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General NPI Number Information
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NPI Number | 1184415887
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Entity Type | Individual
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Provider Name | AMY CORRY CSW
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 5455 RIVER RUN DR
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City | PROVO
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State | UT
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Zip | 84604-7726
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Country | US
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Telephone | 801-226-2550
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Fax |
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Provider Business Mailing Address
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Address Line | 384 S 790 W
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-2238
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Country | US
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Telephone | 503-502-7342
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 13993991-3502
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License Number State | UT
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