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General NPI Number Information
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NPI Number | 1780917732
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Entity Type | Organization
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Legal Business Name | LIFE MOSAICS FAMILY COUNSELING
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 218 N CENTER ST
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City | AMERICAN FORK
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State | UT
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Zip | 84003-1630
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Country | US
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Telephone | 801-770-3030
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Fax | 801-770-2839
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Provider Business Mailing Address
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Address Line | 218 N CENTER ST
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City | AMERICAN FORK
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State | UT
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Zip | 84003-1630
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Country | US
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Telephone | 801-770-3030
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Fax | 801-770-2839
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Authorized Official
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Title or Position | OWNER
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Name | BRADY MATHEWS
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Credential |
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Telephone | 801-770-3030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | UT
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