Individual
TIANA MAKAIWA PARK LOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCADC, CPC-INTERN
Contact information
Practice address
3970 S HOWICK ST UNIT B135, SALT LAKE CITY, UT 84107-1491
(702) 271-9458
Mailing address
3970 S HOWICK ST UNIT B135, SALT LAKE CITY, UT 84107-1491
(702) 271-9458
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
127859346004
UT
101YP2500X
Professional Counselor
0022392
CO
101YP2500X
Professional Counselor
CI0047
NV
Other
Enumeration date
10/20/2010
Last updated
08/06/2025
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