Healthcare Provider Details

I. General information

NPI: 1972248722
Provider Name (Legal Business Name): RICCI HOWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 E BAMBERGER DR STE A
AMERICAN FORK UT
84003-2179
US

IV. Provider business mailing address

263 W AUTUMN CREEK DR
SARATOGA SPRINGS UT
84045-5013
US

V. Phone/Fax

Practice location:
  • Phone: 801-305-3171
  • Fax:
Mailing address:
  • Phone: 678-983-4996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8614433-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: