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NPI Code Detail

MEDICARE: DR. ALISON JANE MUSSO PH.D.

MEDICARE:  DR. ALISON JANE MUSSO  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TA0700XAdult Development & Aging Psychologist1174072501UT
2103TB0200XCognitive & Behavioral Psychologist1174072501UT
3103TC0700XClinical Psychologist1174072501UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111740725003001OTHERUTBCBS
2Q19324OTHERUTSTERLING

General Provider Information

NPI Number : 1346230802
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALISON JANE MUSSO PH.D.
Provider Business Mailing Address
First Line : 2892 COVE LN
Second Line :
City : BOUNTIFUL
State : UT
Zip : 84010-2415
Country : US
Telephone Number : 801-292-7143
Fax Number : 801-478-2781
Provider Business Practice Location Address
First Line : 1545 E 3300 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84106-3370
Country : US
Telephone Number : 801-478-2780
Fax Number : 801-478-2781
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 09/11/2025

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Directions to “ DR. ALISON JANE MUSSO PH.D.” Practice Location

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