Healthcare Provider Details

I. General information

NPI: 1437086568
Provider Name (Legal Business Name): AMELIA KERSEY MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 E 820 N
OREM UT
84097-5481
US

IV. Provider business mailing address

1426 E 820 N
OREM UT
84097-5481
US

V. Phone/Fax

Practice location:
  • Phone: 801-477-0041
  • Fax:
Mailing address:
  • Phone: 801-477-0041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number14284035-3904
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: