Provider Demographics
NPI:1194204115
Name:UTAH THERAPY AND HEALING, PLLC
Entity Type:Organization
Organization Name:UTAH THERAPY AND HEALING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWRY
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:801-899-6797
Mailing Address - Street 1:825 E 4800 S STE 120C
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5557
Mailing Address - Country:US
Mailing Address - Phone:801-899-6797
Mailing Address - Fax:801-446-3999
Practice Address - Street 1:825 E 4800 S STE 120C
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5557
Practice Address - Country:US
Practice Address - Phone:801-899-6797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8597001-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
13971803OtherCAQH
1801153796OtherNPI