# INNSAEI

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639828361
- **Authorized official:** KRISTIN TUDSANDOS (BUSINESS MANAGER)
- **Authorized official phone:** (385) 221-0200

## Contact information

- **Practice address:** 264 W CENTER ST, OREM, UT 84057-4637
- **Practice address phone:** (801) 225-4027
- **Mailing address:** 264 W CENTER ST, OREM, UT 84057-4637

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 03/21/2022
- **Last updated:** 02/20/2023