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General NPI Number Information
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NPI Number | 1700183704
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Entity Type | Organization
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Legal Business Name | CHRISTOFFERSEN PSYCHOLOGICAL SERVICES PC
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 05/09/2011
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Provider Practice Location Address
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Address Line | 437 S BLUFF ST STE 202
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City | ST GEORGE
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State | UT
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Zip | 84770-3555
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Country | US
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Telephone | 435-272-2861
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Fax | 435-674-9380
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Provider Business Mailing Address
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Address Line | 3764 HOLLAND CIR
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City | SANTA CLARA
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State | UT
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Zip | 84765-5377
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Country | US
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Telephone | 435-272-2861
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Fax | 435-275-2887
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. JULIA KAY CHRISTOFFERSEN
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Credential |
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Telephone | 435-272-2861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 7752010-2501
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License Number State | UT
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