Healthcare Provider Details

I. General information

NPI: 1780458323
Provider Name (Legal Business Name): KRISTIN BOWEN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 W 2100 N UNIT 1
CEDAR CITY UT
84721-8505
US

IV. Provider business mailing address

310 W 2100 N UNIT 1
CEDAR CITY UT
84721-8505
US

V. Phone/Fax

Practice location:
  • Phone: 801-471-7930
  • Fax:
Mailing address:
  • Phone: 801-471-7930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number11334836-3902
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: