Healthcare Provider Details

I. General information

NPI: 1932873650
Provider Name (Legal Business Name): REBECCA LOU DALTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 S MAIN ST
EPHRAIM UT
84627-1313
US

IV. Provider business mailing address

PO BOX 595
EPHRAIM UT
84627-0595
US

V. Phone/Fax

Practice location:
  • Phone: 435-283-4690
  • Fax: 435-283-4689
Mailing address:
  • Phone: 435-283-4690
  • Fax: 435-283-4689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: