Healthcare Provider Details

I. General information

NPI: 1629429121
Provider Name (Legal Business Name): LAUREL ANN HILTON SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2016
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5455 N RIVER RUN DR
PROVO UT
84604-7726
US

IV. Provider business mailing address

5455 N RIVER RUN DR
PROVO UT
84604-7726
US

V. Phone/Fax

Practice location:
  • Phone: 801-226-2550
  • Fax: 801-226-8298
Mailing address:
  • Phone: 801-226-2550
  • Fax: 801-226-8298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10834625-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: