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General NPI Number Information
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NPI Number | 1215660733
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Entity Type | Organization
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Legal Business Name | ESPERANZA HOBBY MS LLC
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Dates
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Enumeration Date | 07/01/2022
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 1412 W STATE RD
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-5015
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Country | US
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Telephone | 385-497-1175
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Fax |
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Provider Business Mailing Address
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Address Line | 583 S 900 W APT 206
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-2386
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Country | US
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Telephone | 334-498-0224
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ESPERANZA HOBBY
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Credential | MS LMFT
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Telephone | 334-498-0224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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