Provider Demographics
NPI:1629956941
Name:MOON, AUBREE
Entity type:Individual
Prefix:
First Name:AUBREE
Middle Name:
Last Name:MOON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AUBREE
Other - Middle Name:LOUISE
Other - Last Name:HENKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:554 S WILD INDIGO WAY
Mailing Address - Street 2:
Mailing Address - City:IVINS
Mailing Address - State:UT
Mailing Address - Zip Code:84738-1228
Mailing Address - Country:US
Mailing Address - Phone:425-345-9532
Mailing Address - Fax:
Practice Address - Street 1:40 N 300 E STE 203
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2909
Practice Address - Country:US
Practice Address - Phone:435-572-0518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling