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General NPI Number Information
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NPI Number | 1568164275
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Entity Type | Individual
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Provider Name | LAUREN MICHELLE ATKINSON
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Gender | Female
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 11953 S TETON PASS WAY
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City | HERRIMAN
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State | UT
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Zip | 84096-2789
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Country | US
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Telephone | 801-712-2049
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Fax |
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Provider Business Mailing Address
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Address Line | 170 S 1200 E STE 100
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City | LEHI
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State | UT
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Zip | 84043-8601
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Country | US
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Telephone | 385-236-4500
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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