Healthcare Provider Details

I. General information

NPI: 1073422523
Provider Name (Legal Business Name): BAILIE HORTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 E 9400 S STE 102
SANDY UT
84094-3694
US

IV. Provider business mailing address

870 E 9400 S STE 102
SANDY UT
84094-3694
US

V. Phone/Fax

Practice location:
  • Phone: 385-238-8522
  • Fax: 385-449-9331
Mailing address:
  • Phone: 385-238-8522
  • Fax: 385-449-9331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14297640-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: