Healthcare Provider Details

I. General information

NPI: 1780593608
Provider Name (Legal Business Name): HOPE ELIZABETH DUTSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 W COLUMBIA LN
PROVO UT
84604-2409
US

IV. Provider business mailing address

805 W 2100 N
PROVO UT
84604-1219
US

V. Phone/Fax

Practice location:
  • Phone: 385-349-5001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: