Basic Information
| Provider Information | |||||||||
| NPI: | 1679816789 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORLEY | ||||||||
| FirstName: | TRACY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4444 S 700 E | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841073075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012684887 | ||||||||
| FaxNumber: | 8012684880 | ||||||||
| Practice Location | |||||||||
| Address1: | 1990 W 7800 S | ||||||||
| Address2: | |||||||||
| City: | WEST JORDAN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840884025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012684887 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2013 | ||||||||
| LastUpdateDate: | 03/27/2013 | ||||||||
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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 | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.