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General NPI Number Information
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NPI Number | 1497168207
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Entity Type | Individual
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Provider Name | ERIC K ALLRED LMFT
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Gender | Male
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Dates
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Enumeration Date | 06/09/2014
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Last Update Date | 06/09/2014
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Provider Practice Location Address
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Address Line | 5500 W BAGLEY PARK RD
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City | WEST JORDAN
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State | UT
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Zip | 84081-5697
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Country | US
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Telephone | 801-282-1003
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Fax |
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Provider Business Mailing Address
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Address Line | 5097 W LITTLE WATER PEAK DR
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City | RIVERTON
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State | UT
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Zip | 84096-6435
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Country | US
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Telephone | 801-302-0173
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4914197-3902
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License Number State | UT
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