Healthcare Provider Details

I. General information

NPI: 1598408965
Provider Name (Legal Business Name): LYNN ALDDELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 N 530 E
OREM UT
84097
US

IV. Provider business mailing address

150 S 1000 E
SALT LAKE CITY UT
84102-1443
US

V. Phone/Fax

Practice location:
  • Phone: 801-687-9509
  • Fax:
Mailing address:
  • Phone: 801-823-1988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13418979-3502
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13418979-3501
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: