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Individual

KAREN RUSSELL MORTENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1422 E 820 N, OREM, UT 84097-5481
(801) 644-0726
Mailing address
1124 E 1100 S, CLEARFIELD, UT 84015-1316
(801) 644-0726

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
11151552-3902
UT
106H00000X
Marriage & Family Therapist
Primary
11151552-3904
UT

Other

Enumeration date
10/28/2019
Last updated
08/16/2023
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