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NPI Code Detail

MEDICARE: PEAK PATHWAYS THERAPY

MEDICARE: PEAK PATHWAYS THERAPY
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
1261QM0855XAdolescent and Children Mental Health Clinic/Center
2261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1982384764
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEAK PATHWAYS THERAPY
Provider Business Mailing Address
First Line : 108 W 520 N
Second Line :
City : VINEYARD
State : UT
Zip : 84059-2702
Country : US
Telephone Number : 801-362-8737
Fax Number :
Provider Business Practice Location Address
First Line : 2825 E COTTONWOOD PKWY STE 500
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84121-7060
Country : US
Telephone Number : 801-610-9249
Fax Number :
Authorized Official
Title or Position : SOLE OWNER
Name : BRIANNA MICHELLE DAVIS
Credential : LCSW
Telephone Number : 801-362-8737
Provider Enumeration Date : 07/18/2023
Last Update Date : 08/03/2023

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Directions to “PEAK PATHWAYS THERAPY ” Practice Location

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