Provider Demographics
NPI:1316605603
Name:HURST, ALEXANDRIA JESSILYN (MSW)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:JESSILYN
Last Name:HURST
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 N 2150 W
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-7243
Mailing Address - Country:US
Mailing Address - Phone:909-942-1350
Mailing Address - Fax:
Practice Address - Street 1:51 E 800 N
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1210
Practice Address - Country:US
Practice Address - Phone:435-314-9623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool