Healthcare Provider Details

I. General information

NPI: 1497576961
Provider Name (Legal Business Name): SARAH JANE CHRISTENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH MCMONIGLE

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 S WEST TEMPLE
SOUTH SALT LAKE UT
84115-1816
US

IV. Provider business mailing address

1776 S WEST TEMPLE
SOUTH SALT LAKE UT
84115-1816
US

V. Phone/Fax

Practice location:
  • Phone: 801-880-5775
  • Fax:
Mailing address:
  • Phone: 801-880-5775
  • Fax: 801-340-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-359866
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: