Organization
REGINA TIPPETS PLLC
Active
Other names
Willow Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF TIPPETS (OFFICE MANAGER)
(801) 450-8813
Entity
Organization
Contact information
Practice address
505 NYGREEN ST, GRANTSVILLE, UT 84029-9421
(801) 450-8813
Mailing address
505 NYGREEN ST, GRANTSVILLE, UT 84029-9421
(801) 450-8813
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
289022-6004
UT
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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