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General NPI Number Information
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NPI Number | 1134055387
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Entity Type | Individual
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Provider Name | ASHLYN JOY BIRD
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Gender | Female
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 4933 S 1500 W STE 110
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City | RIVERDALE
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State | UT
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Zip | 84405-7738
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Country | US
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Telephone | 385-330-2818
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Fax |
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Provider Business Mailing Address
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Address Line | 489 E 475 N
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City | OGDEN
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State | UT
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Zip | 84404-3511
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Country | US
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Telephone | 801-358-8309
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14221358-3502
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License Number State | UT
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