Organization
THETA MANAGEMENT CORPORATION
Active
Other names
Theta Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KENDRA A. BERNAL (OFFICE MANAGER)
(801) 852-1400
Entity
Organization
Contact information
Practice address
524 W 300 N, SUITE 102, PROVO, UT 84601-2667
(801) 852-1400
Mailing address
524 W 300 N, SUITE 102, PROVO, UT 84601-2667
(801) 852-1400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
UT
101YM0800X
Mental Health Counselor
—
UT
103T00000X
Psychologist
—
UT
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
UT
1041C0700X
Clinical Social Worker
—
UT
111N00000X
Chiropractor
—
UT
133NN1002X
Nutrition Education Nutritionist
—
UT
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
UT
163WC0400X
Case Management Registered Nurse
—
UT
164W00000X
Licensed Practical Nurse
—
UT
171M00000X
Case Manager/Care Coordinator
—
UT
174H00000X
Health Educator
—
UT
175L00000X
Homeopath
—
UT
246RP1900X
Phlebotomy Technician
—
UT
363L00000X
Nurse Practitioner
Primary
—
UT
Other
Enumeration date
03/06/2013
Last updated
03/06/2013
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