| |
2341 Guardian Cir Saint George UT 84790-8055 | |
(435) 313-4051 | |
Not Available |
Full Name | |
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Speciality | Marriage & Family Therapist |
Location | 2341 Guardian Cir, Saint George, Utah |
Authorized Official Name and Position | Lani Chipman (OWNER) |
Authorized Official Contact | 4357738584 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2341 Guardian Cir Saint George UT 84790-8055 Ph: (435) 773-8584 | 2341 Guardian Cir Saint George UT 84790-8055 Ph: (435) 313-4051 |
NPI Number | 1386223113 |
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Provider Enumeration Date | 04/07/2021 |
Last Update Date | 07/12/2024 |
Certification Date | 07/03/2024 |
Medicare PECOS PAC ID | 4880130418 |
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Medicare Enrollment ID | O20240719000756 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386223113 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
Provider Name | Lani Chipman |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1033532759 PECOS PAC ID: 2961948336 Enrollment ID: I20240722001822 |
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