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Individual

LEXUS DIANE CARR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3195 S MAIN ST STE 180, SALT LAKE CITY, UT 84115-3790
(801) 983-5540
(801) 983-5542
Mailing address
1351 NEWTOWN PIKE, LEXINGTON, KY 40511-1275
(859) 253-1685

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790731081
KY
Enumeration date
03/23/2016
Last updated
02/11/2020
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