Healthcare Provider Details

I. General information

NPI: 1104691807
Provider Name (Legal Business Name): KATHRYN DAWN HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 N 2100 W APT 110
SALT LAKE CITY UT
84116-2994
US

IV. Provider business mailing address

130 N 2100 W APT 110
SALT LAKE CITY UT
84116-2994
US

V. Phone/Fax

Practice location:
  • Phone: 138-531-4892
  • Fax:
Mailing address:
  • Phone: 138-531-4892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC70013100
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberF23-107903
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: