Organization
CREATIVE LIFE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY SUTHERLAND LCSW (THERAPIST)
(502) 741-6065
Entity
Organization
Contact information
Practice address
925 E 900 S, SUITE # 42, SALT LAKE CITY, UT 84105-1401
(801) 657-0897
Mailing address
925 E 900 S, #42, SALT LAKE CITY, UT 84105-1401
(801) 657-0897
(801) 363-6564
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6985612-3501
UT
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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