Healthcare Provider Details

I. General information

NPI: 1083541460
Provider Name (Legal Business Name): AVERI DUNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 NORTH 250 WEST
PROVO UT
84604
US

IV. Provider business mailing address

1567 S 3750 E
SPANISH FORK UT
84660-6472
US

V. Phone/Fax

Practice location:
  • Phone: 801-226-4600
  • Fax:
Mailing address:
  • Phone: 435-590-5076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13416950-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: