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NPI Code Detail

MEDICARE: LENA C RUST

MEDICARE: LENA C RUST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianUT

General Provider Information

NPI Number : 1104788710
Entity Type Code : Individual
Provider Name (Legal Business Name) : LENA C RUST
Provider Business Mailing Address
First Line : 252 W BROOKLYN AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84101-3024
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 252 W BROOKLYN AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84101-3024
Country : US
Telephone Number : 801-845-3117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “ LENA C RUST ” Practice Location

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