Provider Demographics
NPI:1053145318
Name:SMITH, AURORA KATHERINE
Entity type:Individual
Prefix:
First Name:AURORA
Middle Name:KATHERINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 N 2350 W
Mailing Address - Street 2:
Mailing Address - City:FARR WEST
Mailing Address - State:UT
Mailing Address - Zip Code:84404-5177
Mailing Address - Country:US
Mailing Address - Phone:801-872-8757
Mailing Address - Fax:801-872-8757
Practice Address - Street 1:5286 W 5725 S
Practice Address - Street 2:
Practice Address - City:HOOPER
Practice Address - State:UT
Practice Address - Zip Code:84315
Practice Address - Country:US
Practice Address - Phone:801-889-8809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician