Individual
MELINDA FOWLKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
(801) 428-3402
Mailing address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
13417425-3501
UT
171M00000X
Case Manager/Care Coordinator
Primary
13417425-3501
UT
171M00000X
Case Manager/Care Coordinator
Primary
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Other
Enumeration date
01/05/2022
Last updated
04/29/2026
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