MEDICARE: KATHERINE ALLEN

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
1	106H00000X	Marriage & Family Therapist		UT

General Provider Information

NPI Number	:	1508382862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE ALLEN

Provider Business Mailing Address
First Line	:	2655 S LAKE ERIE DR STE B
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-7351
Country	:	US
Telephone Number	:	801-759-5298
Fax Number	:

Provider Business Practice Location Address
First Line	:	2655 S LAKE ERIE DR
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-7350
Country	:	US
Telephone Number	:	385-441-4800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2017
Last Update Date	:	03/18/2025

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