| Wiconi Counseling Center | |
|
1133 N Main St Ste 128 Layton UT 84041-4830 | |
| (801) 541-7049 | |
| Not Available |
| Full Name | Wiconi Counseling Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1133 N Main St Ste 128, Layton, Utah |
| Authorized Official Name and Position | Kimberly Mack (OWNER) |
| Authorized Official Contact | 8015038093 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wiconi Counseling Center 1133 N Main St Ste 128 Layton UT 84041-4830 Ph: (801) 541-7049 | Wiconi Counseling Center 1133 N Main St Ste 128 Layton UT 84041-4830 Ph: (801) 541-7049 |
| NPI Number | 1861050783 |
|---|---|
| Provider Enumeration Date | 06/05/2019 |
| Last Update Date | 12/18/2019 |
| Certification Date | 12/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861050783 | NPI | - | NPPES |
| 1598208928 | Other | TYPE 1 NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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