Provider Demographics
NPI:1427727791
Name:GALTEN, ALICIA ANN
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:ANN
Last Name:GALTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:ANN
Other - Last Name:MEADS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:271 TEMPLE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-5574
Mailing Address - Country:US
Mailing Address - Phone:707-580-4546
Mailing Address - Fax:
Practice Address - Street 1:1392 W TURF FARM WAY STE 1-153
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-5587
Practice Address - Country:US
Practice Address - Phone:801-935-5796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician