Provider Demographics
NPI:1326495813
Name:MOSLEY, ALICIA
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:MOSLEY
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 1:2183 W MAIN ST # A209
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-6760
Mailing Address - Country:US
Mailing Address - Phone:801-448-6286
Mailing Address - Fax:801-373-0639
Practice Address - Street 1:2183 W MAIN ST # A209
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-6760
Practice Address - Country:US
Practice Address - Phone:801-448-6286
Practice Address - Fax:801-373-0639
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12224264-35011041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator