Provider Demographics
NPI:1902456932
Name:MOXON, HANNAH JOY (BSW)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:JOY
Last Name:MOXON
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5198 N UNIVERSITY AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-6010
Mailing Address - Country:US
Mailing Address - Phone:801-487-0499
Mailing Address - Fax:
Practice Address - Street 1:724 E 2100 S STE B
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-1830
Practice Address - Country:US
Practice Address - Phone:801-487-0499
Practice Address - Fax:801-487-7005
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program