Organization
SUNDANCE CANYON THERAPY, COACHING, AND CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY ERICKSON LCMHC (THERAPIST)
(801) 678-4198
Entity
Organization
Contact information
Practice address
180 N UNIVERSITY AVE STE 270, PROVO, UT 84601-5648
(801) 678-4198
Mailing address
4832 W FIRMONT DR, SOUTH JORDAN, UT 84009-8291
(801) 678-4198
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
10471569-0160
UT
Other
Enumeration date
08/13/2017
Last updated
08/13/2017
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