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General NPI Number Information
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NPI Number | 1104040351
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Entity Type | Individual
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Provider Name | SHARON LEWIS BURT LMFT
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 433 SOUTH 500 EAST
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City | AMERICAN FORK
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State | UT
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Zip | 84003-2527
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Country | US
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Telephone | 180-121-6800
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Fax | 801-216-8001
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Provider Business Mailing Address
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Address Line | 4379 MILE HIGH DR.
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City | PROVO
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State | UT
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Zip | 84604-6308
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Country | US
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Telephone | 180-143-4431
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 6212924-3902
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License Number State | UT
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