Healthcare Provider Details

I. General information

NPI: 1215743000
Provider Name (Legal Business Name): ANGELA VEST CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 RED CLIFFS DR
ST GEORGE UT
84790-5457
US

IV. Provider business mailing address

2533 E 3770 S
ST GEORGE UT
84790-6220
US

V. Phone/Fax

Practice location:
  • Phone: 435-673-6446
  • Fax:
Mailing address:
  • Phone: 505-553-8676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14189567-3502
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: