Individual
SUSAN R NATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, PHD
Contact information
Practice address
263 COUNTRY CLB STE 101, STANSBURY PARK, UT 84074-9602
(435) 841-4060
Mailing address
263 COUNTRY CLB STE 101, STANSBURY PARK, UT 84074-9602
(307) 382-6606
(307) 382-9167
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
486
WY
101YM0800X
Mental Health Counselor
Primary
781141-6004
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NAT304951
BLUE CROSS BLUE SHIELD
WY
Enumeration date
04/07/2008
Last updated
03/31/2021
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