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NPI Code Detail

MEDICARE: CHRISTINA LYNN COVERDELL

MEDICARE: CHRISTINA LYNN COVERDELL
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 : 1366251670
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA LYNN COVERDELL
Provider Business Mailing Address
First Line : 15112 S HALTER WAY
Second Line :
City : BLUFFDALE
State : UT
Zip : 84065-1886
Country : US
Telephone Number : 916-949-4436
Fax Number :
Provider Business Practice Location Address
First Line : 3002 W 12600 S
Second Line :
City : RIVERTON
State : UT
Zip : 84065-7119
Country : US
Telephone Number : 801-930-0411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2025
Last Update Date : 01/01/2025

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Directions to “ CHRISTINA LYNN COVERDELL ” Practice Location

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