Basic Information
| Provider Information | |||||||||
| NPI: | 1235357526 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILSON-DAVIES | ||||||||
| FirstName: | ALESIA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW, MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 660 SOUTH 200 EAST | ||||||||
| Address2: | SUITE 308 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013552846 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 660 SOUTH 200 EAST | ||||||||
| Address2: | SUITE 308 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8017737060 | ||||||||
| FaxNumber: | 8017746100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 04/13/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 309023-3501 | UT | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.