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NPI Code Detail

MEDICARE: BIG VALLEY THERAPY LLC

MEDICARE: BIG VALLEY THERAPY LLC
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
1106H00000XMarriage & Family Therapist

General Provider Information

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

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Directions to “BIG VALLEY THERAPY LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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