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General NPI Number Information
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NPI Number | 1942880075
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Entity Type | Organization
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Legal Business Name | WILLOW SHORE COUNSELING, LLC
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 76 W MAIN ST STE 3
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City | AMERICAN FORK
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State | UT
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Zip | 84003-1683
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Country | US
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Telephone | 385-519-4585
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Fax |
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Provider Business Mailing Address
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Address Line | 1123 W 400 N
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City | LEHI
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State | UT
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Zip | 84043-5957
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Country | US
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Telephone | 801-404-3225
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AISLINN BURKE
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Credential | LMFT
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Telephone | 801-404-3225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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