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General NPI Number Information
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NPI Number | 1336012806
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Entity Type | Organization
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Legal Business Name | BIG VALLEY THERAPY LLC
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 59 W 9000 S STE 4
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City | SANDY
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State | UT
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Zip | 84070-2008
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Country | US
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Telephone | 801-901-0559
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Fax |
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Provider Business Mailing Address
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Address Line | 59 W 9000 S STE 4
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City | SANDY
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State | UT
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Zip | 84070-2008
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Country | US
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Telephone | 801-901-0559
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | JOSHUA KEI OTANI
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Credential | MS
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Telephone | 801-901-0559
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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 |
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License Number State |
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