Healthcare Provider Details

I. General information

NPI: 1154017671
Provider Name (Legal Business Name): MARJANN OBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 S MAIN ST STE 103
SPANISH FORK UT
84660-4679
US

IV. Provider business mailing address

212 S MAIN ST STE 103
SPANISH FORK UT
84660-4679
US

V. Phone/Fax

Practice location:
  • Phone: 801-990-4304
  • Fax:
Mailing address:
  • Phone: 801-990-4304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13965840-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: