Salt Lake Therapy, PLLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Salt Lake City, UT. Organization (NPI-2).
NPI number1093594830
StatusActive
Last updated in NPPESSep 21, 2023
Details
- NPI
- 1093594830
- Entity type
- Organization (NPI-2)
- Legal business name
- Salt Lake Therapy, PLLC
- Organization subpart
- No
- Enumeration date
- Sep 21, 2023
- Certification date
- Sep 21, 2023
- Last updated
- Sep 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
370 E South Temple Ste 240Salt Lake City, UT 84111-1262
Phone 801-669-2055
Mailing address
370 E South Temple Ste 240Salt Lake City, UT 84111-1262
Phone 801-669-2055
Authorized official
Joellyn Orcutt Manville
Owner
8016692055
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