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General NPI Number Information
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NPI Number | 1578404422
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Entity Type | Individual
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Provider Name | DYLAN DUSOE
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Gender | Male
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 9662 S 700 E
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City | SANDY
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State | UT
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Zip | 84070-3590
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Country | US
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Telephone | 801-233-8577
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Fax | 801-233-8748
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Provider Business Mailing Address
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Address Line | 9662 S 700 E
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City | SANDY
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State | UT
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Zip | 84070-3590
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Country | US
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Telephone | 801-233-8577
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Fax | 801-233-8748
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 14252696-3502
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License Number State | UT
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