Individual
ANGIE SUZANNE HENDREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
731 E 8600 S, SANDY, UT 84094-6312
(801) 561-9987
(801) 561-9987
Mailing address
4973 BRIDLE CREEK DR, WEST JORDAN, UT 84081-3667
(801) 455-8958
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
33024-6004
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33020460001001
REGENCE PROVIDER ID
UT
01
—
870476172-008
VALLEY MENTAL HEALTH
UT
01
—
89204
PEHP PROVIDER ID
UT
Enumeration date
05/23/2006
Last updated
10/10/2008
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