Individual
MINDY JO VANDERLOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPCI
Contact information
Practice address
1390 S 1100 E STE 203, SALT LAKE CITY, UT 84105-2463
(801) 510-5231
Mailing address
1390 S 1100 E STE 203, SALT LAKE CITY, UT 84105-2463
(801) 510-5231
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7380258-6009
UT
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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