Provider Demographics
NPI:1497935373
Name:EDMINSTER, CATHERINE ANNE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANNE
Last Name:EDMINSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 S UNION PARK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-6706
Mailing Address - Country:US
Mailing Address - Phone:801-214-9422
Mailing Address - Fax:
Practice Address - Street 1:7400 S UNION PARK AVE STE 201
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-6706
Practice Address - Country:US
Practice Address - Phone:801-214-9422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
UT8254152-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health