Individual
MRS. AIMEE E FASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
920 HERITAGE PARK BLVD STE 200H, LAYTON, UT 84041-5645
(385) 393-4804
(801) 217-8162
Mailing address
920 HERITAGE PARK BLVD STE 200H, LAYTON, UT 84041-5645
(385) 393-4804
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7775888-6009
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
08/20/2012
Last updated
01/29/2020
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