Healthcare Provider Details

I. General information

NPI: 1831712397
Provider Name (Legal Business Name): CAYLIN MORGAN MONTOYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 S 700 E STE 9
SALT LAKE CITY UT
84107-2581
US

IV. Provider business mailing address

4000 S 700 E STE 9
SALT LAKE CITY UT
84107-2581
US

V. Phone/Fax

Practice location:
  • Phone: 575-430-5439
  • Fax:
Mailing address:
  • Phone: 575-430-5439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13860527-6004
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: