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General NPI Number Information
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NPI Number | 1861901381
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Entity Type | Individual
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Provider Name | ALYSSA THOMAS LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 2363 N HILL FIELD RD
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City | LAYTON
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State | UT
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Zip | 84041-6909
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Country | US
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Telephone | 801-525-4645
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 S COURTNEY WAY UNIT 3
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City | WEST HAVEN
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State | UT
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Zip | 84401-3573
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Country | US
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Telephone | 801-309-0011
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 13089720-3501
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License Number State | UT
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