Healthcare Provider Details

I. General information

NPI: 1124889704
Provider Name (Legal Business Name): MRS. DENALEE WILKINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11978 S REDWOOD RD
RIVERTON UT
84065-7403
US

IV. Provider business mailing address

564 W SYCAMORE LN
ALPINE UT
84004-2804
US

V. Phone/Fax

Practice location:
  • Phone: 801-330-1339
  • Fax:
Mailing address:
  • Phone: 801-330-1339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12554991-6011
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number12554991-3503
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: