Healthcare Provider Details

I. General information

NPI: 1629956941
Provider Name (Legal Business Name): AUBREE MOON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AUBREE LOUISE HENKE

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 N 300 E STE 203
ST GEORGE UT
84770-2909
US

IV. Provider business mailing address

554 S WILD INDIGO WAY
IVINS UT
84738-1228
US

V. Phone/Fax

Practice location:
  • Phone: 435-572-0518
  • Fax:
Mailing address:
  • Phone: 425-345-9532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: