Healthcare Provider Details

I. General information

NPI: 1407526684
Provider Name (Legal Business Name): SAGE CROOK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 W SERGEANT COURT DR STE 204
SARATOGA SPRINGS UT
84045-5809
US

IV. Provider business mailing address

24 W SERGEANT COURT DR STE 204
SARATOGA SPRINGS UT
84045-5809
US

V. Phone/Fax

Practice location:
  • Phone: 801-987-6333
  • Fax:
Mailing address:
  • Phone: 801-987-6333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number14236200-4201
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB722024
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: