Individual
CAROL ELAINE LAWRENCECOSTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
339 E 3900 S STE 155, SALT LAKE CITY, UT 84107-1978
(801) 263-1056
(801) 261-3701
Mailing address
339 E 3900 S STE 155, SALT LAKE CITY, UT 84107-1978
(801) 263-1056
(801) 261-3701
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
131826-3502
UT
101YM0800X
Mental Health Counselor
Primary
131826-3502
UT
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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