Healthcare Provider Details

I. General information

NPI: 1235931577
Provider Name (Legal Business Name): SHAILEE DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2172 E 7200 S
SPANISH FORK UT
84660-9340
US

IV. Provider business mailing address

289 E 1100 N
SALEM UT
84653-5793
US

V. Phone/Fax

Practice location:
  • Phone: 866-805-1199
  • Fax:
Mailing address:
  • Phone: 801-822-4416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12312663-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: