Healthcare Provider Details

I. General information

NPI: 1104634039
Provider Name (Legal Business Name): ASHLEY MARIE ARNETT CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2024
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 E STATE RD STE 100
AMERICAN FORK UT
84003-2277
US

IV. Provider business mailing address

150 N MAIN ST
PLEASANT GROVE UT
84062-2240
US

V. Phone/Fax

Practice location:
  • Phone: 801-305-3171
  • Fax:
Mailing address:
  • Phone: 801-842-9734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13427692-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: