Mind Full Therapy, LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Slc, UT. Organization (NPI-2).
NPI number1336735232
StatusActive
Last updated in NPPESDec 15, 2020
Details
- NPI
- 1336735232
- Entity type
- Organization (NPI-2)
- Legal business name
- Mind Full Therapy, LLC
- Organization subpart
- No
- Enumeration date
- Dec 15, 2020
- Certification date
- Dec 15, 2020
- Last updated
- Dec 15, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
2605 E 3300 SSlc, UT 84109-2728
Phone 801-828-6139
Mailing address
2827 S Wainwright RdSalt Lake City, UT 84109-1819
Phone 801-828-6139
Authorized official
Kendyl M Leasure
Owner
8018286139
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