Provider Demographics
NPI:1760068241
Name:MEDLEY, HOPE (CSW)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:
Last Name:MEDLEY
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:HOPE
Other - Middle Name:
Other - Last Name:WOTHERSPOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:132 W 2200 S
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-5630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4778 N 300 W STE 100
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-7709
Practice Address - Country:US
Practice Address - Phone:801-607-5004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker