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General NPI Number Information
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NPI Number | 1013411156
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Entity Type | Organization
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Legal Business Name | ESSENCE OF HEALTH
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 806 E MAIN ST
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City | TREMONTON
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State | UT
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Zip | 84337-6733
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Country | US
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Telephone | 435-279-0402
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Fax |
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Provider Business Mailing Address
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Address Line | 8765 WILD ROSE LN
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City | PORTAGE
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State | UT
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Zip | 84331-8924
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Country | US
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Telephone | 435-279-0402
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/THERAPIST
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Name | KARIN ADDIE CUMMINS
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Credential | LCSW
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Telephone | 435-279-0402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7763855-3501
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License Number State | UT
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