# RECREATE THERAPY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013442052
- **Authorized official:** MRS. AVA MARIE CRUMP HANSON MS, LMFT (OWNER/MARRIAGE AND FAMILY THERAPIST)
- **Authorized official phone:** (435) 632-7894

## Contact information

- **Practice address:** 2535 S HIGHWAY 89, STE 4, BRIGHAM CITY, UT 84302-6729
- **Practice address phone:** (435) 494-1214
- **Mailing address:** 275 W 1750 S, APT \#1, PERRY, UT 84302-4903
- **Mailing address phone:** (435) 494-1214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 9066126-3902 | UT | Yes |

## Other

- **Enumeration date:** 04/27/2017
- **Last updated:** 04/27/2017