Healthcare Provider Details

I. General information

NPI: 1225941677
Provider Name (Legal Business Name): MYRIAD HOUSE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 S MAIN ST STE 108
SOUTH SALT LAKE UT
84115-5002
US

IV. Provider business mailing address

520 N MARION ST
SALT LAKE CITY UT
84116-2645
US

V. Phone/Fax

Practice location:
  • Phone: 801-839-4007
  • Fax:
Mailing address:
  • Phone: 801-839-4007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: DORIS MARILYN ROBINSON
Title or Position: OWNER
Credential: LCSW
Phone: 801-839-4007