Provider Demographics
NPI:1487445953
Name:OPFAR, ALIZA LUCILLE (ACMHC)
Entity type:Individual
Prefix:
First Name:ALIZA
Middle Name:LUCILLE
Last Name:OPFAR
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:ALIZA
Other - Middle Name:LUCILLE OPFAR
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ACMHC
Mailing Address - Street 1:1826 N 400 W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2140
Mailing Address - Country:US
Mailing Address - Phone:469-534-6188
Mailing Address - Fax:
Practice Address - Street 1:1256 S STATE ST STE 201
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-8239
Practice Address - Country:US
Practice Address - Phone:801-600-0308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14222278-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health