Healthcare Provider Details
I. General information
NPI: 1417800731
Provider Name (Legal Business Name): ALTERITAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1508 S CARTERVILLE RD
OREM UT
84097-7243
US
IV. Provider business mailing address
336 E UNIVERSITY PKWY # 1077
OREM UT
84058-7602
US
V. Phone/Fax
- Phone: 360-559-2302
- Fax: 360-682-5645
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AARON
ROLLAND
BURDGE
Title or Position: OWNER
Credential: PH.D.
Phone: 425-753-1813