Healthcare Provider Details

I. General information

NPI: 1619896123
Provider Name (Legal Business Name): APRIL MAY ROSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4607 MIDLAND DR
WEST HAVEN UT
84401-9507
US

IV. Provider business mailing address

4910 S 2125 W
ROY UT
84067-2509
US

V. Phone/Fax

Practice location:
  • Phone: 801-732-0060
  • Fax:
Mailing address:
  • Phone: 801-989-8527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number14294896-4003
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: