Organization
MIND, BODY, SOUL, UTAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES NUTTALL LCSW (OWNER)
(801) 906-8780
Entity
Organization
Contact information
Practice address
699 E SOUTH TEMPLE, SUITE 300, SALT LAKE CITY, UT 84102-1142
(801) 906-8780
Mailing address
699 E SOUTH TEMPLE, SUITE 300, SALT LAKE CITY, UT 84102-1142
(801) 906-8780
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/26/2010
Last updated
04/27/2017
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