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General NPI Number Information
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NPI Number | 1164716122
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Entity Type | Individual
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Provider Name | ALICIA M POWER MFTI
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Gender | Female
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 55 SOUTH 500 NORTH
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City | HEBER CITY
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State | UT
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Zip | 84032
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Country | US
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Telephone | 435-654-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 68 N 200 W
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City | HEBER CITY
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State | UT
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Zip | 84032-1804
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Country | US
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Telephone | 801-671-5191
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 7586289-3904
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License Number State | UT
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