Healthcare Provider Details

I. General information

NPI: 1356537542
Provider Name (Legal Business Name): NATALIE COX HERNDON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATALIE HERNDON HOWARD M.S.

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1174 W LE ROSIER CT
WEST JORDAN UT
84088-9076
US

IV. Provider business mailing address

1174 W LE ROSIER CT
WEST JORDAN UT
84088-9076
US

V. Phone/Fax

Practice location:
  • Phone: 601-757-3382
  • Fax: 801-713-1387
Mailing address:
  • Phone: 601-757-3382
  • Fax: 801-713-1387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number7954817-2501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7954817-2501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: