Organization
SACRED HOOP HEALING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEIL ROGER GOSLIN LPC (COUNSELOR)
(435) 868-1040
Entity
Organization
Contact information
Practice address
210 W 200 N, SUITE 106, PROVO, UT 84601-2852
(801) 400-8460
Mailing address
210 W 200 N, SUITE 106, PROVO, UT 84601-2852
(801) 400-8460
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
327723-6004
UT
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
327723-6004
UT
101YM0800X
Mental Health Counselor
327723-6004
UT
101YP2500X
Professional Counselor
327723-6004
UT
106H00000X
Marriage & Family Therapist
327723-6004
UT
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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