Healthcare Provider Details

I. General information

NPI: 1871429001
Provider Name (Legal Business Name): EMILY ELIZABETH LUTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 N 500 W
PROVO UT
84604-3337
US

IV. Provider business mailing address

415 N WALL ST APT 2
SALT LAKE CITY UT
84103-1881
US

V. Phone/Fax

Practice location:
  • Phone: 801-357-7850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number142445023601
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: