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NPI Code Detail

MEDICARE: DR. HEIDEMARIE LEX PHD

MEDICARE:  DR. HEIDEMARIE  LEX  PHD
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 : 1699374439
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEIDEMARIE LEX PHD
Provider Business Mailing Address
First Line : 3125 E KENNEDY DR APT 605
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-2156
Country : US
Telephone Number : 857-284-3080
Fax Number :
Provider Business Practice Location Address
First Line : 3125 E KENNEDY DR APT 605
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-2156
Country : US
Telephone Number : 857-284-3080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2020
Last Update Date : 10/22/2020

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Directions to “ DR. HEIDEMARIE LEX PHD” Practice Location

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