Provider Demographics
NPI:1689319345
Name:TODD, LEXI
Entity Type:Individual
Prefix:
First Name:LEXI
Middle Name:
Last Name:TODD
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 1:75 E FORT UNION BLVD STE C118
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-5512
Mailing Address - Country:US
Mailing Address - Phone:801-792-0570
Mailing Address - Fax:
Practice Address - Street 1:75 E FORT UNION BLVD STE C118
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-5512
Practice Address - Country:US
Practice Address - Phone:801-792-0570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker