Healthcare Provider Details

I. General information

NPI: 1487576385
Provider Name (Legal Business Name): SAVANNA WILLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1149 S 450 W
BRIGHAM CITY UT
84302-6707
US

IV. Provider business mailing address

291 E 1270 N # 291
NORTH LOGAN UT
84341-2392
US

V. Phone/Fax

Practice location:
  • Phone: 801-392-0942
  • Fax:
Mailing address:
  • Phone: 208-861-8545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: