Healthcare Provider Details

I. General information

NPI: 1508793555
Provider Name (Legal Business Name): ARYANA YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1157 E 300 N
PROVO UT
84606-3539
US

IV. Provider business mailing address

750 N FREEDOM BLVD
PROVO UT
84601-1677
US

V. Phone/Fax

Practice location:
  • Phone: 801-494-0880
  • Fax:
Mailing address:
  • Phone: 801-373-4760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14284918-3503
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: