Individual
MALLORY DEMOTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
1258 W SOUTH JORDAN PKWY, SOUTH JORDAN, UT 84095-4711
(801) 255-1155
Mailing address
3228 W ROLLING CREEK WAY, SOUTH JORDAN, UT 84095-9380
(801) 680-7532
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
12386010-6004
UT
Other
Enumeration date
08/13/2020
Last updated
12/27/2023
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