| Trailside Mobile Therapy | |
|
1719 N 400 W Farmington UT 84025-3972 | |
| (801) 644-0173 | |
| Not Available |
| Full Name | Trailside Mobile Therapy |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1719 N 400 W, Farmington, Utah |
| Authorized Official Name and Position | Stephanie Randolph-seng (OWNER) |
| Authorized Official Contact | 8016440173 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trailside Mobile Therapy 1719 N 400 W Farmington UT 84025-3972 Ph: (801) 644-0173 | Trailside Mobile Therapy 1719 N 400 W Farmington UT 84025-3972 Ph: (801) 644-0173 |
| NPI Number | 1639044043 |
|---|---|
| Provider Enumeration Date | 10/07/2025 |
| Last Update Date | 10/07/2025 |
| Certification Date | 10/06/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639044043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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