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General NPI Number Information
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NPI Number | 1093000598
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Entity Type | Individual
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Provider Name | ALISA CHAMBERLAIN MORLEY
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Gender | Female
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 356 S MAIN ST
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City | BLANDING
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State | UT
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Zip | 84511-3830
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Country | US
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Telephone | 435-678-2992
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Fax | 435-678-3116
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Provider Business Mailing Address
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Address Line | 735 S 200 W STE 1
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City | BLANDING
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State | UT
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Zip | 84511-3923
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Country | US
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Telephone | 435-678-2992
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Fax | 435-678-3116
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8311698-3502
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License Number State | UT
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