Provider Demographics
NPI:1215660733
Name:ESPERANZA HOBBY MS LLC
Entity type:Organization
Organization Name:ESPERANZA HOBBY MS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESPERANZA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBBY
Authorized Official - Suffix:
Authorized Official - Credentials:MS LMFT
Authorized Official - Phone:334-498-0224
Mailing Address - Street 1:583 S 900 W APT 206
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-2386
Mailing Address - Country:US
Mailing Address - Phone:334-498-0224
Mailing Address - Fax:
Practice Address - Street 1:1412 W STATE RD
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-5015
Practice Address - Country:US
Practice Address - Phone:385-497-1175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health