Organization
EXPANSIVE HORIZONS COUNSELING & PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZA SANDERSON PSYD (PRESIDENT)
(801) 360-6955
Entity
Organization
Contact information
Practice address
228 WEST 200 SOUTH, SUITE 2E, KAMAS, UT 84036
(801) 360-6955
Mailing address
596 ASH COURT, KAMAS, UT 84036
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8493271-6004
UT
251S00000X
Community/Behavioral Health Agency
8493271-6004
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447584511
—
UT
Enumeration date
11/04/2016
Last updated
11/04/2016
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