Organization
PRIMARY CHILDREN'S CENTER FOR COUNSELING
Active
Parent organization
INTERMOUNTAIN HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN HEALTHCARE
Authorized official
PROF. DORANN MITCHELL LCSW (DIRECTOR, PCCC)
(801) 265-3000
Entity
Organization
Contact information
Practice address
5770 S 1500 W, #G, SALT LAKE CITY, UT 84123-5216
(801) 265-3000
(801) 265-3025
Mailing address
5770 S 1500 W, #G, SALT LAKE CITY, UT 84123-5216
(801) 265-3000
(801) 265-3025
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
380804-3501
UT
Other
Enumeration date
09/15/2008
Last updated
09/15/2008
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