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General NPI Number Information
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NPI Number | 1275412637
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Entity Type | Organization
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Legal Business Name | HER WELLNESS THERAPY, PLLC
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 4568 S HIGHLAND DR STE 380
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City | MILLCREEK
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State | UT
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Zip | 84117-4213
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Country | US
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Telephone | 385-272-8906
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Fax |
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Provider Business Mailing Address
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Address Line | 4568 S HIGHLAND DR STE 380
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City | MILLCREEK
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State | UT
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Zip | 84117-4213
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Country | US
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Telephone | 385-272-8906
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Fax |
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Authorized Official
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Title or Position | CEO, PRACTITIONER
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Name | ELIZABETH BOSEN
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Credential |
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Telephone | 385-272-8906
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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 |
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License Number State |
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