Healthcare Provider Details

I. General information

NPI: 1376477075
Provider Name (Legal Business Name): STEPHANIE MARIE GAGLIARDO LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE MARIE MEYERS LMT

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 N STATE ST
OREM UT
84057-4747
US

IV. Provider business mailing address

928 S 825 W
SPRINGVILLE UT
84663-5065
US

V. Phone/Fax

Practice location:
  • Phone: 801-434-4555
  • Fax:
Mailing address:
  • Phone: 801-830-9348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number5833208-4701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: