Organization
MOUNTAIN VIEW FAMILY THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE PENUNURI LCSW (OWNER/CLINICAL DIRECTOR)
(801) 930-0411
Entity
Organization
Contact information
Practice address
1273 W 12600 S STE 403, RIVERTON, UT 84065-7111
(801) 930-0411
Mailing address
1273 W 12600 S STE 403, RIVERTON, UT 84065-7111
(801) 930-0411
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
08/28/2018
Last updated
11/16/2019
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