Most Relevant Information
Provider Data
  | NPI Number: | 1003549197 | 
| Provider Name: | ASHLEIGH SOUTHWELL | 
| Entity Type: | Individual | 
| Taxonomy Code: | 106S00000X | 
| Specialty: | Behavior Technician | 
| License Number: | 
Most Important Dates
  | Enumeration Date: | 07/06/2022 | 
| Last Updated: | 07/06/2022 | 
Provider Practice Location
  5558 S 1900 W
      
      TAYLORSVILLE
      UT
      841299007
  Practice Location Phone/Fax
      | Phone: | 8012555131 | 
| Fax: | 
Provider Mailing Location
  6013 S REDWOOD RD
      
      TAYLORSVILLE
      UT
      841235220
  Provider Mailing Phone/Fax
      | Phone: | |
| Fax: |