Individual
MRS. ALISSA JORDAN FERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
571 S 690 E, HYRUM, UT 84319-1788
(801) 717-9165
Mailing address
571 S 690 E, HYRUM, UT 84319-1788
(801) 717-9165
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10378762-3501
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/28/2016
Last updated
11/08/2022
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