Healthcare Provider Details

I. General information

NPI: 1982115192
Provider Name (Legal Business Name): ASI PILIVI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2017
Last Update Date: 10/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13073 S WHEATFIELD WAY
DRAPER UT
84020-9253
US

IV. Provider business mailing address

2033 W APPLE FARMS RD
WEST VALLEY CITY UT
84119-6193
US

V. Phone/Fax

Practice location:
  • Phone: 801-495-0946
  • Fax:
Mailing address:
  • Phone: 385-297-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: