Organization
MIND, BODY, SOUL UTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHUCK NUTTALL (LCSW)
(801) 906-8780
Entity
Organization
Contact information
Practice address
699 E SOUTH TEMPLE STE 145, SALT LAKE CITY, UT 84102-4200
(801) 906-8780
Mailing address
699 E SOUTH TEMPLE STE 145, SALT LAKE CITY, UT 84102-4200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
86376063502
UT
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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