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Organization

INTIMATE RELATIONSHIPS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIFFANY RUSSELL LMFT (OWNER)
(801) 850-7063
Entity
Organization

Contact information

Practice address
520 E 770 N, OREM, UT 84097-4101
(801) 850-7063
Mailing address
520 E 770 N, OREM, UT 84097-4101
(801) 850-7063

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
10/04/2023
Last updated
10/04/2023
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