Provider Demographics
NPI:1205002730
Name:WIGNALL, KAREN R (LPC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:R
Last Name:WIGNALL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 S 590 E
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-6448
Mailing Address - Country:US
Mailing Address - Phone:801-221-3700
Mailing Address - Fax:
Practice Address - Street 1:578 S 590 E
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-6448
Practice Address - Country:US
Practice Address - Phone:801-221-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT148435428101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health