Individual
MS. CRYSTAL NICOLE GARDUNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
1522 SOUTH 1100 EAST, SALT LAKE CITY, UT 84105
(801) 467-1200
(801) 467-1210
Mailing address
1522 SOUTH 1100 EAST, SALT LAKE CITY, UT 84105
(801) 467-1200
(801) 467-1210
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
81615876009
UT
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/25/2011
Last updated
04/11/2012
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