Healthcare Provider Details

I. General information

NPI: 1710796750
Provider Name (Legal Business Name): ALYSSA CROWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALYSSA SHERRELL

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 W 1800 N STE A
CLINTON UT
84015-8503
US

IV. Provider business mailing address

1180 W 925 N
LAYTON UT
84041-4083
US

V. Phone/Fax

Practice location:
  • Phone: 801-217-3133
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: