Healthcare Provider Details

I. General information

NPI: 1104740448
Provider Name (Legal Business Name): EMMA RASBAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 N 1750 W
SPRINGVILLE UT
84663-4989
US

IV. Provider business mailing address

10731 N CYPRESS
CEDAR HILLS UT
84062-8522
US

V. Phone/Fax

Practice location:
  • Phone: 801-335-9382
  • Fax:
Mailing address:
  • Phone: 801-335-9382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-463109
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: