Provider Demographics
NPI:1598487381
Name:CRESS, SASHA RENEE
Entity Type:Individual
Prefix:MRS
First Name:SASHA
Middle Name:RENEE
Last Name:CRESS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SASHA
Other - Middle Name:RENEE
Other - Last Name:BEASLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 N 1400 W
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-8627
Mailing Address - Country:US
Mailing Address - Phone:704-402-2044
Mailing Address - Fax:
Practice Address - Street 1:5974 FASHION POINT DR STE 140
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4838
Practice Address - Country:US
Practice Address - Phone:801-683-1062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ1-21-54053103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst