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Organization

MIND FULL THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KENDYL M LEASURE CMHC (OWNER)
(801) 828-6139
Entity
Organization

Contact information

Practice address
2605 E 3300 S, SLC, UT 84109-2728
(801) 828-6139
Mailing address
2827 S WAINWRIGHT RD, SALT LAKE CITY, UT 84109-1819
(801) 828-6139

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
12/15/2020
Last updated
12/15/2020
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