Individual
MRS. DOROTHY L. IMPERIAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
699 E SOUTH TEMPLE, SUITE 300, SALT LAKE CITY, UT 84102-1142
(801) 631-3926
Mailing address
PO BOX 71736, SALT LAKE CITY, UT 84171-0736
(801) 944-4092
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5121495-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107035592101
IHC
UT
01
—
51214953501001
BCBS
UT
01
—
82597
PEHP P33
UT
01
—
885542
DMBA P33
UT
Enumeration date
08/18/2006
Last updated
07/08/2007
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