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General NPI Number Information
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NPI Number | 1710471594
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Entity Type | Organization
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Legal Business Name | INTERNAL RESOLUTIONS
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 06/15/2018
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Provider Practice Location Address
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Address Line | 375 S CARBON AVE
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City | PRICE
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State | UT
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Zip | 84501-2909
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Country | US
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Telephone | 386-243-1744
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Fax |
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Provider Business Mailing Address
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Address Line | 330 S 100 W
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City | PRICE
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State | UT
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Zip | 84501-2904
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Country | US
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Telephone | 402-460-8767
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | HEATHER TOWNDROW
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Credential | LCSW
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Telephone | 402-460-8767
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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 | 8309794-3501
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License Number State | UT
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