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General NPI Number Information
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NPI Number | 1811751126
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Entity Type | Organization
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Legal Business Name | OGDEN THERAPY COOPERATIVE
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 707 24TH ST STE 1A
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City | OGDEN
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State | UT
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Zip | 84401-2580
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Country | US
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Telephone | 801-475-5225
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Fax |
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Provider Business Mailing Address
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Address Line | 2127 N 600 E
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City | NORTH OGDEN
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State | UT
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Zip | 84414-2811
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Country | US
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Telephone | 801-682-3494
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY SHAPIRO
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Credential | LCSW, MPA
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Telephone | 801-475-5225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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