Healthcare Provider Details

I. General information

NPI: 1689596652
Provider Name (Legal Business Name): LYNSIE ATALIFO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W 180 N
OREM UT
84057-4432
US

IV. Provider business mailing address

1120 W 180 N
OREM UT
84057-4432
US

V. Phone/Fax

Practice location:
  • Phone: 801-471-4393
  • Fax:
Mailing address:
  • Phone: 801-471-4393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: