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Organization
EAST MOUNTAIN THERAPY
Active
Organization
EAST MOUNTAIN THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY BRYSON JINDRA CMHC (MENTAL HEALTH COUNSELOR)
(801) 358-0967
Entity
Organization
Contact information
Practice address
721 N 530 E, OREM, UT 84097-4105
(801) 358-0967
Mailing address
2283 ALASKA AVE, PROVO, UT 84606-6707
(801) 358-0967
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
7025125-6004
UT
Other
Enumeration date
06/12/2014
Last updated
06/12/2014
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