Organization
CROSSROADS FAMILY COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE R. WATERS (SOLE MEMBER)
(801) 597-7673
Entity
Organization
Contact information
Practice address
12569 S 2700 W STE 202B, RIVERTON, UT 84065-7182
(801) 597-7673
Mailing address
12569 S 2700 W STE 202B, RIVERTON, UT 84065-7182
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
5087227-6004
UT
Other
Enumeration date
01/24/2010
Last updated
01/24/2010
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