Provider Demographics
NPI:1396199584
Name:BIRD, WILLIAM WES
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WES
Last Name:BIRD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:EPHRAIM
Mailing Address - State:UT
Mailing Address - Zip Code:84627-0595
Mailing Address - Country:US
Mailing Address - Phone:435-283-4690
Mailing Address - Fax:435-283-4689
Practice Address - Street 1:45 WEST 700 SOUTH
Practice Address - Street 2:
Practice Address - City:EPHRAIM
Practice Address - State:UT
Practice Address - Zip Code:84627-0595
Practice Address - Country:US
Practice Address - Phone:435-283-4690
Practice Address - Fax:435-283-4689
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor