Provider Demographics
NPI:1194207365
Name:COX, DAVID (SUDC, SAP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:COX
Suffix:
Gender:M
Credentials:SUDC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 S 200 E
Mailing Address - Street 2:
Mailing Address - City:LINDON
Mailing Address - State:UT
Mailing Address - Zip Code:84042-2047
Mailing Address - Country:US
Mailing Address - Phone:180-178-4945
Mailing Address - Fax:
Practice Address - Street 1:145 S 200 E
Practice Address - Street 2:
Practice Address - City:LINDON
Practice Address - State:UT
Practice Address - Zip Code:84042-2047
Practice Address - Country:US
Practice Address - Phone:180-178-4945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6835878-6006101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)