Healthcare Provider Details

I. General information

NPI: 1144154873
Provider Name (Legal Business Name): SARA ALECIA WALTERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 E COTTONWOOD PKWY STE 500
SALT LAKE CITY UT
84121-7060
US

IV. Provider business mailing address

423 W SANDBAR WAY
SPANISH FORK UT
84660-4622
US

V. Phone/Fax

Practice location:
  • Phone: 385-442-5895
  • Fax:
Mailing address:
  • Phone: 385-895-7206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: