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2811 W Lizzi Cv South Jordan UT 84095-7961 | |
| (435) 592-4150 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2811 W Lizzi Cv, South Jordan, Utah |
| Authorized Official Name and Position | Natalie P. Townsend (OWNER) |
| Authorized Official Contact | 4355924150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2811 W Lizzi Cv South Jordan UT 84095-7961 Ph: (435) 592-4150 | 2811 W Lizzi Cv South Jordan UT 84095-7961 Ph: (435) 592-4150 |
| NPI Number | 1447756028 |
|---|---|
| Provider Enumeration Date | 04/03/2018 |
| Last Update Date | 10/29/2024 |
| Certification Date | 10/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447756028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 76313116004 (Utah) | Primary |
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