Individual
CAROLYN M COLLINSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Mailing address
750 N FREEDOM BLVD STE 300, PROVO, UT 84601-1690
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12670537-6018
UT
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/02/2021
Last updated
04/23/2024
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