Provider Demographics
NPI:1790233773
Name:MASON, ADRIANNA MAE EWING (CSWI)
Entity Type:Individual
Prefix:MISS
First Name:ADRIANNA
Middle Name:MAE EWING
Last Name:MASON
Suffix:
Gender:F
Credentials:CSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6332
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84402-6332
Mailing Address - Country:US
Mailing Address - Phone:888-801-1556
Mailing Address - Fax:877-544-4630
Practice Address - Street 1:2909 WASHINGTON BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-3744
Practice Address - Country:US
Practice Address - Phone:888-801-1556
Practice Address - Fax:877-544-4630
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker