| Madre Tierra Counseling & Consulting Llc | |
|
3763 S Secord St Salt Lake City UT 84115-4771 | |
| (801) 865-4076 | |
| Not Available |
| Full Name | Madre Tierra Counseling & Consulting Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3763 S Secord St, Salt Lake City, Utah |
| Authorized Official Name and Position | Yvette Sonia Gonzalez (OWNER) |
| Authorized Official Contact | 8018654076 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madre Tierra Counseling & Consulting Llc 2331 W Josie Ln Taylorsville UT 84129-5351 Ph: (801) 865-4076 | Madre Tierra Counseling & Consulting Llc 3763 S Secord St Salt Lake City UT 84115-4771 Ph: (801) 865-4076 |
| NPI Number | 1942859707 |
|---|---|
| Provider Enumeration Date | 09/05/2019 |
| Last Update Date | 09/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942859707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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