=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639555246
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLEE ROSE HUNT LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2015
-----------------------------------------------------
Last Update Date | 01/13/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 826 N. 100 E STE 6
-----------------------------------------------------
City | SPANISH FORK
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84660
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-995-8542
-----------------------------------------------------
Fax | 435-674-3175
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 826 N. 100 E STE 6
-----------------------------------------------------
City | SPANISH FORK
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84660
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-995-8542
-----------------------------------------------------
Fax | 435-674-3175
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 89384193502
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------