Healthcare Provider Details

I. General information

NPI: 1578339552
Provider Name (Legal Business Name): BROOKE HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 S MAIN ST STE 302
ST GEORGE UT
84770-7188
US

IV. Provider business mailing address

870 E 9400 S STE 102
SANDY UT
84094-3694
US

V. Phone/Fax

Practice location:
  • Phone: 385-238-8522
  • Fax:
Mailing address:
  • Phone: 385-238-8522
  • Fax: 385-449-9331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10858218-3502
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: