Provider Demographics
NPI:1245219278
Name:MAGOULAS, PILAR LENGLET (MS, CGC)
Entity Type:Individual
Prefix:MRS
First Name:PILAR
Middle Name:LENGLET
Last Name:MAGOULAS
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:MS
Other - First Name:PILAR
Other - Middle Name:ANDREA
Other - Last Name:LENGLET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:1029 LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105
Mailing Address - Country:US
Mailing Address - Phone:801-583-0652
Mailing Address - Fax:801-585-7252
Practice Address - Street 1:50 N MEDICAL DR
Practice Address - Street 2:SOM 2C412
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-581-8943
Practice Address - Fax:801-585-7252
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5329433-3602170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS