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NPI Code Detail

MEDICARE: JOSEPH MAKOUSKE

MEDICARE: JOSEPH MAKOUSKE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1497438360
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH MAKOUSKE
Provider Business Mailing Address
First Line : 3004 S 500 E
Second Line :
City : SOUTH SALT LAKE
State : UT
Zip : 84106-1357
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 660 S 200 E STE 205
Second Line :
City : SLC
State : UT
Zip : 84111-3835
Country : US
Telephone Number : 801-359-2256
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2023
Last Update Date : 08/08/2023

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Directions to “ JOSEPH MAKOUSKE ” Practice Location

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