Individual
ANITA M CHIDESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STUDENT INTERN
Contact information
Practice address
411 GRANT ST, SALT LAKE CITY, UT 84116-2725
(801) 359-8862
(207) 359-8510
Mailing address
411 GRANT ST, SALT LAKE CITY, UT 84116-2725
(801) 359-8862
(207) 359-8510
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/02/2011
Last updated
05/02/2011
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