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NPI Code Detail

MEDICARE: SCOTT WILTBANK

MEDICARE: SCOTT WILTBANK
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
1101YM0800XMental Health CounselorUT

General Provider Information

NPI Number : 1740121441
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT WILTBANK
Provider Business Mailing Address
First Line : 1039 W 40 S
Second Line :
City : OREM
State : UT
Zip : 84058-5265
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 75 E FORT UNION BLVD STE C118
Second Line :
City : MIDVALE
State : UT
Zip : 84047-5512
Country : US
Telephone Number : 801-654-0772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ SCOTT WILTBANK ” Practice Location

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