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NPI Code Detail

MEDICARE: CANDICE TOWNSEND

MEDICARE: CANDICE TOWNSEND
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 : 1871354530
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDICE TOWNSEND
Provider Business Mailing Address
First Line : 6803 S 700 E
Second Line :
City : MIDVALE
State : UT
Zip : 84047-1362
Country : US
Telephone Number : 385-289-9645
Fax Number :
Provider Business Practice Location Address
First Line : 1570 S 1100 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-2441
Country : US
Telephone Number : 801-438-6387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2024
Last Update Date : 01/19/2024

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Directions to “ CANDICE TOWNSEND ” Practice Location

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