Healthcare Provider Details

I. General information

NPI: 1205761947
Provider Name (Legal Business Name): EMILY BURGON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

766 N 2860 E STE 201&202
ST GEORGE UT
84790-8906
US

IV. Provider business mailing address

766 N 2860 E STE 201&202
ST GEORGE UT
84790-8906
US

V. Phone/Fax

Practice location:
  • Phone: 435-227-5506
  • Fax:
Mailing address:
  • Phone: 435-227-5506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: