Healthcare Provider Details

I. General information

NPI: 1134064546
Provider Name (Legal Business Name): CIERA PULVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9924 S 3265 W
SOUTH JORDAN UT
84095-9035
US

IV. Provider business mailing address

9924 S 3265 W
SOUTH JORDAN UT
84095-9035
US

V. Phone/Fax

Practice location:
  • Phone: 385-588-7223
  • Fax:
Mailing address:
  • Phone: 385-588-7223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-492071
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: