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1500 E 2700 S Hurricane UT 84737-4000 | |
| (435) 635-0636 | |
| (435) 304-0004 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1500 E 2700 S, Hurricane, Utah |
| Authorized Official Name and Position | Norman Edward Thibault (FOUNDER AND CEO) |
| Authorized Official Contact | 4356350636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1500 E 2700 S Hurricane UT 84737-4000 Ph: (435) 635-0636 | 1500 E 2700 S Hurricane UT 84737-4000 Ph: (435) 635-0636 |
| NPI Number | 1699252635 |
|---|---|
| Provider Enumeration Date | 07/23/2018 |
| Last Update Date | 07/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699252635 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 63382 (Utah) | Primary |
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