Individual
MCKENZIE LYNN RODARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDC
Contact information
Practice address
716 E 4500 S STE S260, MURRAY, UT 84107-3611
(385) 474-6111
Mailing address
716 E 4500 S STE S260, MURRAY, UT 84107-3611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162327053
—
UT
Enumeration date
07/02/2020
Last updated
07/02/2020
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