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Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder)

Provider NPI: 1841583234

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
560 S STATE ST STE G-1 OREM, UT 84058-6354 US
Tel: 801-802-8608  Fax: 801-221-1042

Business Mailing Address:
1112 E 360 S  PROVO, UT 84606-5254 US
Tel: 801-717-0886  Fax: --

NPI Information:
NPI: 1841583234
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Addiction (Substance Use Disorder)

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 101YA0400X





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