MEDICARE: ALYSON R AINSCOUGH APC

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
1	101YP2500X	Professional Counselor	7778912-6009	UT

General Provider Information

NPI Number	:	1497054829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSON R AINSCOUGH APC

Provider Business Mailing Address
First Line	:	2549 MELBOURNE STREET
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106
Country	:	US
Telephone Number	:	801-815-9138
Fax Number	:

Provider Business Practice Location Address
First Line	:	2549 MELBOURNE ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-4003
Country	:	US
Telephone Number	:	801-815-9138
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2011
Last Update Date	:	03/24/2011

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