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NPI Code Detail

MEDICARE: MILESTONES INTEGRATIVE HEALING

MEDICARE: MILESTONES INTEGRATIVE HEALING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1205390259
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILESTONES INTEGRATIVE HEALING
Provider Business Mailing Address
First Line : 4578 S HIGHLAND DR STE 320
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-4214
Country : US
Telephone Number : 801-505-9137
Fax Number :
Provider Business Practice Location Address
First Line : 4578 S HIGHLAND DR STE 320
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-4214
Country : US
Telephone Number : 801-505-9137
Fax Number :
Authorized Official
Title or Position : MENTAL HEALTH COUNSELOR
Name : MISS DANIELLE FAST
Credential : CMHC
Telephone Number : 801-505-9137
Provider Enumeration Date : 01/24/2019
Last Update Date : 01/24/2019

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Directions to “MILESTONES INTEGRATIVE HEALING ” Practice Location

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