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General NPI Number Information
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NPI Number | 1952517286
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Entity Type | Individual
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Provider Name | PHYLLIS STELL CROWLEY MS, RD, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 05/24/2026
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Provider Practice Location Address
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Address Line | 7907 HONEYWOOD COVE DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84121-5916
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Country | US
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Telephone | 801-944-0956
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Fax |
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Provider Business Mailing Address
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Address Line | 7907 HONEYWOOD COVE DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84121-5916
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Country | US
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Telephone | 801-944-0956
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 375264-4901
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 0000000124
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License Number State | TN
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