Provider Demographics
NPI:1881992212
Name:LANDON, ERIC SCOTT (BS, CTRS, TRS, MSW-I)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:SCOTT
Last Name:LANDON
Suffix:
Gender:
Credentials:BS, CTRS, TRS, MSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 N 1330 W
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-5111
Mailing Address - Country:US
Mailing Address - Phone:801-960-3040
Mailing Address - Fax:
Practice Address - Street 1:165 N 1330 W STE A1
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-5116
Practice Address - Country:US
Practice Address - Phone:801-960-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT390200000X
UT294118-4002225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program