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General NPI Number Information
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NPI Number | 1861049678
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Entity Type | Individual
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Provider Name | EMILY MARIE FATALI LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/26/2019
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 2655 S LAKE ERIE DR STE B
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City | WEST VALLEY CITY
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State | UT
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Zip | 84120-7351
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Country | US
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Telephone | 801-608-5750
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Fax |
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Provider Business Mailing Address
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Address Line | 963 W DEBONAIR DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84116-2120
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Country | US
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Telephone | 913-424-5756
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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 | 113056563502
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License Number State | UT
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