Healthcare Provider Details
I. General information
NPI: 1902315898
Provider Name (Legal Business Name): ZULIE LANGARICA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/24/2017
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
117 W 400 S
SALT LAKE CITY UT
84101-1916
US
IV. Provider business mailing address
117 W 400 S
SALT LAKE CITY UT
84101-1916
US
V. Phone/Fax
- Phone: 801-428-3445
- Fax:
- Phone: 801-428-4257
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: