Healthcare Provider Details

I. General information

NPI: 1346230802
Provider Name (Legal Business Name): ALISON JANE MUSSO PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 E 3300 S
SALT LAKE CITY UT
84106-3370
US

IV. Provider business mailing address

2892 COVE LN
BOUNTIFUL UT
84010-2415
US

V. Phone/Fax

Practice location:
  • Phone: 801-478-2780
  • Fax: 801-478-2781
Mailing address:
  • Phone: 801-292-7143
  • Fax: 801-478-2781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number1174072501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number1174072501
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1174072501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: