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General NPI Number Information
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NPI Number | 1003272048
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Entity Type | Individual
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Provider Name | IWALANI DIPRIMA ACMHC
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Gender | Female
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Dates
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Enumeration Date | 01/06/2016
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Last Update Date | 01/06/2016
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Provider Practice Location Address
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Address Line | 3149 N HWY 89 200
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City | PLEASANT VIEW
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State | UT
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Zip | 84404-1201
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Country | US
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Telephone | 801-782-6600
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Fax | 801-782-6551
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Provider Business Mailing Address
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Address Line | 3149 N HWY 89 200
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City | PLEASANT VIEW
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State | UT
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Zip | 84404-1201
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Country | US
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Telephone | 801-782-6600
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Fax | 801-782-6551
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5499509-6009
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License Number State | UT
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