Healthcare Provider Details

I. General information

NPI: 1487136057
Provider Name (Legal Business Name): LAUREN RENAE EEKHOFF MS, LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2018
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 S COTTONWOOD ST STE 100
MURRAY UT
84107-5701
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-7400
  • Fax:
Mailing address:
  • Phone: 801-507-7400
  • Fax: 801-507-3505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number10896220-3602
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: