Individual
MS. CASSITY KRISCHELLE CONDIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
2696 N UNIVERSITY AVE STE 104B, PROVO, UT 84604-3827
(801) 477-0551
Mailing address
PO BOX 971464, OREM, UT 84097-1464
(801) 477-0551
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6362482-6004
UT
101YP2500X
Professional Counselor
Primary
6362482-6004
UT
Other
Enumeration date
05/01/2012
Last updated
05/01/2012
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