Healthcare Provider Details

I. General information

NPI: 1720418205
Provider Name (Legal Business Name): HEATHER RUBEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date: 06/24/2026
Reactivation Date: 08/14/2026

III. Provider practice location address

1422 E 820 N
OREM UT
84097-5481
US

IV. Provider business mailing address

1422 E 820 N
OREM UT
84097-5481
US

V. Phone/Fax

Practice location:
  • Phone: 801-855-6552
  • Fax: 801-465-1917
Mailing address:
  • Phone:
  • Fax: 801-465-1917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-58574
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: