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General NPI Number Information
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NPI Number | 1871145227
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Entity Type | Organization
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Legal Business Name | PINYON PINE COUNSELING
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Dates
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Enumeration Date | 07/15/2019
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Last Update Date | 07/15/2019
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Provider Practice Location Address
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Address Line | 1240 E 100 S BLDG 23
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City | SAINT GEORGE
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State | UT
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Zip | 84790-3001
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Country | US
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Telephone | 435-652-1202
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Fax |
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Provider Business Mailing Address
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Address Line | 1630 E 2450 S UNIT 121
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City | SAINT GEORGE
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State | UT
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Zip | 84790-6234
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Country | US
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Telephone | 435-668-4983
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MR. CRAIG L SKOUSEN
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Credential | LCSW
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Telephone | 435-668-4983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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