Organization
LITTLE BLACK CAT COUNSELING AND HEALING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE IRENE MEDINA PSYD (OWNER)
(385) 377-5995
Entity
Organization
Contact information
Practice address
715 E 3900 S STE 103, SALT LAKE CITY, UT 84107-2570
(385) 377-5995
Mailing address
715 E 3900 S STE 103, SALT LAKE CITY, UT 84107-2570
(385) 377-5995
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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