Healthcare Provider Details

I. General information

NPI: 1093774101
Provider Name (Legal Business Name): JOSH PAUL BIESINGER L.M.F.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5667 S REDWOOD RD UNIT 5C
TAYLORSVILLE UT
84123-5433
US

IV. Provider business mailing address

323 EAST 200 SOUTH
FARMINGTON UT
84025
US

V. Phone/Fax

Practice location:
  • Phone: 801-755-8799
  • Fax:
Mailing address:
  • Phone: 801-755-8799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number94-275396-3902
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: