Individual
SHELLY EYRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3051 W MAPLE LOOP DR, SUITE 201, LEHI, UT 84043-5621
(801) 824-0722
(801) 341-8218
Mailing address
PO BOX 28128, SALT LAKE CITY, UT 84127-0128
(801) 824-0722
(801) 341-8218
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1393513501
UT
251S00000X
Community/Behavioral Health Agency
139351-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52896107802001
BCBS OF UTAH
UT
01
—
814241
DMBA
UT
01
—
87925
PEHP
UT
Enumeration date
08/31/2006
Last updated
02/15/2017
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