Healthcare Provider Details

I. General information

NPI: 1801723903
Provider Name (Legal Business Name): AIMEE D ZWAHLEN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1258 W SOUTH JORDAN PKWY STE 202
SOUTH JORDAN UT
84095-4712
US

IV. Provider business mailing address

1258 W SOUTH JORDAN PKWY STE 202
SOUTH JORDAN UT
84095-4712
US

V. Phone/Fax

Practice location:
  • Phone: 801-255-1155
  • Fax:
Mailing address:
  • Phone: 801-255-1155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13408417-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: