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General NPI Number Information
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NPI Number | 1790355840
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Entity Type | Organization
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Legal Business Name | THERAPY TRANSFORMED - MWP
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 3585 N UNIVERSITY AVE STE 250
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City | PROVO
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State | UT
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Zip | 84604-6622
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Country | US
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Telephone | 801-899-3558
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Fax |
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Provider Business Mailing Address
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Address Line | 520 N MAIN ST STE 353
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City | HEBER CITY
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State | UT
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Zip | 84032-1216
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MEGAN PERRY
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Credential |
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Telephone | 801-899-3558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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