Provider Demographics
NPI:1558009787
Name:ALLAN, ASHLEE FAY
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:FAY
Last Name:ALLAN
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 S 1930 E
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-5833
Mailing Address - Country:US
Mailing Address - Phone:385-497-2869
Mailing Address - Fax:
Practice Address - Street 1:1220 N MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-4025
Practice Address - Country:US
Practice Address - Phone:801-210-7216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12417844-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker