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NPI Code Detail

MEDICARE: LYNDIE REBECCA SMITH KAMALAMALAMA CMHCI

MEDICARE: LYNDIE REBECCA SMITH KAMALAMALAMA CMHCI
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 : 1306540992
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNDIE REBECCA SMITH KAMALAMALAMA CMHCI
Provider Business Mailing Address
First Line : 870 E 9400 S STE 100
Second Line :
City : SANDY
State : UT
Zip : 84094-3677
Country : US
Telephone Number : 801-252-5036
Fax Number : 801-252-5036
Provider Business Practice Location Address
First Line : 870 E 9400 S STE 100
Second Line :
City : SANDY
State : UT
Zip : 84094-3677
Country : US
Telephone Number : 801-252-5036
Fax Number : 801-252-5036
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2023
Last Update Date : 03/28/2023

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