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Individual

LORI JOANN GROAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
525 E 4500 S, SUITE # F125, SALT LAKE CITY, UT 84107-2995
(801) 268-1564
(801) 268-1565
Mailing address
525 E 4500 S, SUITE # F125, SALT LAKE CITY, UT 84107-2995
(801) 268-1564
(801) 268-1565

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8100590-6009
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8100590-6009
STATE OF UTAH
Enumeration date
06/29/2012
Last updated
04/20/2015
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