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NPI Code Detail

MEDICARE: SHANNON IRVINE ADAMS

MEDICARE: SHANNON IRVINE ADAMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist11425184-3904UT

General Provider Information

NPI Number : 1881231413
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON IRVINE ADAMS
Provider Business Mailing Address
First Line : 1010 E 275 N
Second Line :
City : OREM
State : UT
Zip : 84097-5085
Country : US
Telephone Number : 801-885-3358
Fax Number :
Provider Business Practice Location Address
First Line : 481 E 1000 S STE D
Second Line :
City : PLEASANT GROVE
State : UT
Zip : 84062-3716
Country : US
Telephone Number : 801-899-2559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2019
Last Update Date : 12/02/2019

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Directions to “ SHANNON IRVINE ADAMS ” Practice Location

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