Doctor Name: | IWALANI DIPRIMA |
NPI Number: | 1003272048 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ACMHC |
License Number: | 5499509-6009 |
Business Practice Address: | 3149 N Hwy 89 200 Pleasant View, UT - 844041201 |
Business Phone Number: | 8017826600 |
Business Fax Number: | 8017826551 |
Mailing Address: | 3149 N Hwy 89, 200 PLEASANT VIEW |
State: | UT |
Postal Code: | 844041201 |
Phone Number: | 8017826600 |
Fax Number: | 8017826551 |
NPI Enumeration Date: | 01/06/2016 |
NPI Last Update Date: | 01/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 5499509-6009 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |