Organization
ADOLESCENT, CHILD AND FAMILY THERAPY CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSE B. OLDS APRN (PRESIDENT)
(801) 652-4937
Entity
Organization
Contact information
Practice address
370 E SOUTH TEMPLE, STE 550, SALT LAKE CITY, UT 84111-1206
(801) 652-4937
Mailing address
515 S 700 E, STE 3A, SALT LAKE CITY, UT 84102-2873
(801) 652-4937
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
2152474405
UT
Other
Enumeration date
03/27/2007
Last updated
08/22/2020
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