Provider Demographics
NPI:1558050575
Name:TEERLINK, TAYLOR DENISE STEPHENS
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:DENISE STEPHENS
Last Name:TEERLINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:DENISE
Other - Last Name:STEPHENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2086 E PINE CONE RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-4941
Mailing Address - Country:US
Mailing Address - Phone:385-207-4872
Mailing Address - Fax:
Practice Address - Street 1:24 W SERGEANT COURT DR STE 204
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-5809
Practice Address - Country:US
Practice Address - Phone:801-987-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician