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Individual

ALEXANDRA GILLESPIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFTA

Contact information

Practice address
130 S MAIN ST STE 119, LOGAN, UT 84321-5387
(385) 312-9844
Mailing address
30 FAIRWAY LN, LOGAN, UT 84321-5942
(734) 589-7954

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
11603442-3904
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11603442-3904
STATE OF UTAH ASSOCIATE MARRIAGE AND FAMILY THERAPY LICENSE
UT
Enumeration date
01/05/2022
Last updated
01/05/2022
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