| Mind Full Therapy, Llc | |
|
2605 E 3300 S Slc UT 84109-2728 | |
| (801) 828-6139 | |
| Not Available |
| Full Name | Mind Full Therapy, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2605 E 3300 S, Slc, Utah |
| Authorized Official Name and Position | Kendyl M Leasure (OWNER) |
| Authorized Official Contact | 8018286139 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Full Therapy, Llc 2827 S Wainwright Rd Salt Lake City UT 84109-1819 Ph: (801) 828-6139 | Mind Full Therapy, Llc 2605 E 3300 S Slc UT 84109-2728 Ph: (801) 828-6139 |
| NPI Number | 1336735232 |
|---|---|
| Provider Enumeration Date | 12/15/2020 |
| Last Update Date | 12/15/2020 |
| Certification Date | 12/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336735232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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