Healthcare Provider Details

I. General information

NPI: 1316501331
Provider Name (Legal Business Name): SARAH METTENET
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 S 700 E APT 2
SALT LAKE CITY UT
84102-2801
US

IV. Provider business mailing address

9048 S GREENWOOD DR
SANDY UT
84070-2844
US

V. Phone/Fax

Practice location:
  • Phone: 801-419-3485
  • Fax:
Mailing address:
  • Phone: 801-419-3485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-63508
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: