MEDICARE: MRS. MEREDITH HOOD CMHC

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	101YM0800X	Mental Health Counselor	87935336004	UT

General Provider Information

NPI Number	:	1568724631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MEREDITH HOOD CMHC

Provider Business Mailing Address
First Line	:	1543 E 900 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105-1621
Country	:	US
Telephone Number	:	406-570-6945
Fax Number	:

Provider Business Practice Location Address
First Line	:	1543 E 900 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84105-1621
Country	:	US
Telephone Number	:	406-570-6945
Fax Number	:

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

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	10/02/2013

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