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NPI Code Detail

MEDICARE: TIMOTHY BLAIR CHRISTENSEN CMHC

MEDICARE: TIMOTHY BLAIR CHRISTENSEN 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
1101YM0800XMental Health Counselor9415842-6004UT

General Provider Information

NPI Number : 1942703947
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY BLAIR CHRISTENSEN CMHC
Provider Business Mailing Address
First Line : 2730 S FOREST SPRING WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84106-2240
Country : US
Telephone Number : 801-706-3022
Fax Number :
Provider Business Practice Location Address
First Line : 4465 S 900 E STE 150
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-3944
Country : US
Telephone Number : 435-248-2089
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2018
Last Update Date : 03/15/2018

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Directions to “ TIMOTHY BLAIR CHRISTENSEN CMHC” Practice Location

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