Individual
GINA M ZUPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACMHC
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11508440-6009
UT
1041C0700X
Clinical Social Worker
11508440-6009
UT
Other
Enumeration date
11/01/2019
Last updated
12/07/2023
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