Provider Demographics
NPI:1659947331
Name:ALDRICH, DAVID JAMES (MSW,PHD IN EDUCATION)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:ALDRICH
Suffix:
Gender:M
Credentials:MSW,PHD IN EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2609
Mailing Address - Country:US
Mailing Address - Phone:435-962-0705
Mailing Address - Fax:
Practice Address - Street 1:175 N 100 W # N103
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2049
Practice Address - Country:US
Practice Address - Phone:435-962-0705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1260126035011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical