Individual
SAMANTHA MOEAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1881 N 1120 W, PROVO, UT 84604-1180
(801) 472-8382
Mailing address
4465 S 900 E STE 150, SALT LAKE CITY, UT 84124-3944
(801) 472-8382
(510) 480-1207
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
98831513501
UT
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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