Individual
MARY ALISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
433 S 500 E, AMERICAN FORK, UT 84003
(801) 216-8000
Mailing address
433 S 500 E, AMERICAN FORK, UT 84003-2527
(801) 216-8000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041S0200X
School Social Worker
—
UT
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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