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NPI 1144049289

NPI 1144049289 : MAKENNA BEIGH : SALT LAKE CITY, UT

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General NPI Number Information
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    NPI Number           |    1144049289
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    Entity Type          |    Individual 
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    Provider Name        |    MAKENNA BEIGH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/07/2024
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    Last Update Date     |    12/04/2025
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Provider Practice Location Address
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    Address Line         |    81 N MARIO CAPECCHI DR 
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    City                 |    SALT LAKE CITY
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    State                |    UT
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    Zip                  |    84113-1125
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    Country              |    US
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    Telephone            |    801-872-8114
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2255 S 300 E UNIT A335 
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    City                 |    SOUTH SALT LAKE
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    State                |    UT
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    Zip                  |    84115-2898
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    Country              |    US
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    Telephone            |    916-217-8115
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    170300000X
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    Taxonomy Name        |    Genetic Counselor (M.S.)
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    License Number       |    14006016-3602
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    License Number State |    UT
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