Individual
ANGELIQUE MARY PONCELET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1753 SIDEWINDER DR # S200, PARK CITY, UT 84060-7258
(435) 649-9079
Mailing address
1753 SIDEWINDER DR # S200, PARK CITY, UT 84060-7258
(435) 649-9079
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6822558-6004
UT
Other
Enumeration date
03/12/2010
Last updated
03/12/2010
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