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NPI Code Detail

MEDICARE: KATE JOHNSON MFT

MEDICARE: KATE JOHNSON MFT
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
1106H00000XMarriage & Family Therapist12219884-3904UT

General Provider Information

NPI Number : 1972256907
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATE JOHNSON MFT
Provider Business Mailing Address
First Line : 3040 W 7140 S
Second Line :
City : WEST JORDAN
State : UT
Zip : 84084-2920
Country : US
Telephone Number : 801-641-6011
Fax Number :
Provider Business Practice Location Address
First Line : 4505 S WASATCH BLVD STE 290
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-4204
Country : US
Telephone Number : 385-695-5949
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2022
Last Update Date : 01/31/2022

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Directions to “ KATE JOHNSON MFT” Practice Location

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