Healthcare Provider Details

I. General information

NPI: 1255249645
Provider Name (Legal Business Name): TEREZA TVRDIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 W 3500 S STE F
WEST VALLEY CITY UT
84119-2668
US

IV. Provider business mailing address

2830 S 2750 E
SALT LAKE CITY UT
84109-2017
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: