Healthcare Provider Details

I. General information

NPI: 1821603812
Provider Name (Legal Business Name): ANNE LOW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 S OREM BLVD
OREM UT
84058-6979
US

IV. Provider business mailing address

331 E 4450 N
PROVO UT
84604-5108
US

V. Phone/Fax

Practice location:
  • Phone: 801-875-2892
  • Fax:
Mailing address:
  • Phone: 801-310-1490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11295953-3502
License Number StateUT

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: