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Individual

ALISHA GOWEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
89 W MAIN ST, VERNAL, UT 84078-2535
(435) 790-1524
Mailing address
89 W MAIN ST, VERNAL, UT 84078-2535
(435) 790-1524

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
5869439-3503
UT
1041C0700X
Clinical Social Worker
Primary
5869439-3501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5869439-3501
DOPL
UT
01
5869439-3503
DOPL
UT
Enumeration date
06/24/2019
Last updated
09/18/2022
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