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Individual

KHADIJA TAHIRA EWALT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
168 E COLLEGE AVE UNIT C, CEDAR CITY, UT 84720-3369
(435) 572-0340
Mailing address
168 E COLLEGE AVE UNIT C, CEDAR CITY, UT 84720-3369
(435) 572-0340

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH61625777
WA
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
12/13/2019
Last updated
04/04/2025
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