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General NPI Number Information
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NPI Number | 1932998929
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Entity Type | Individual
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Provider Name | MARA LEFLER
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Gender | Female
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 124 S 400 E STE 230
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City | SALT LAKE CITY
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State | UT
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Zip | 84111-5313
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Country | US
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Telephone | 801-920-7112
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Fax |
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Provider Business Mailing Address
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Address Line | 307 S 200 E
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City | BOUNTIFUL
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State | UT
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Zip | 84010-4905
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Country | US
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Telephone | 801-573-8104
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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 | 14215526-3904
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License Number State | UT
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