Provider Demographics
NPI:1235798281
Name:DOWNEY, TRESA LEONTINE
Entity Type:Individual
Prefix:
First Name:TRESA
Middle Name:LEONTINE
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 E TABERNACLE ST
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-2978
Mailing Address - Country:US
Mailing Address - Phone:801-872-3489
Mailing Address - Fax:
Practice Address - Street 1:249 E TABERNACLE ST
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2978
Practice Address - Country:US
Practice Address - Phone:801-872-3489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician