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General NPI Number Information
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NPI Number | 1114818747
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Entity Type | Individual
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Provider Name | BROOKE WITTMAN CMHC
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Gender | Female
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 10434 S 1055 W STE 201
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-1522
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Country | US
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Telephone | 801-655-5450
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Fax | 385-225-9327
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Provider Business Mailing Address
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Address Line | 1433 N 1200 W
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City | OREM
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State | UT
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Zip | 84057-2449
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Country | US
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Telephone | 801-655-5450
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Fax | 385-225-9327
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 13408610-6004
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License Number State | UT
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