Healthcare Provider Details

I. General information

NPI: 1326923962
Provider Name (Legal Business Name): TAYLOR LAUREN BLAYWAYS AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3741 W 12600 S STE 100
RIVERTON UT
84065-7215
US

IV. Provider business mailing address

PO BOX 30180
SALT LAKE CITY UT
84130-0180
US

V. Phone/Fax

Practice location:
  • Phone: 833-577-3422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number14235754-4101
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: