Provider Demographics
NPI:1619297827
Name:CHRISTOPHE, ANTHONY JEROME (THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JEROME
Last Name:CHRISTOPHE
Suffix:
Gender:M
Credentials:THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 S 600 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1007
Mailing Address - Country:US
Mailing Address - Phone:801-322-1001
Mailing Address - Fax:
Practice Address - Street 1:2450 E FT UNION BLVD
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-3337
Practice Address - Country:US
Practice Address - Phone:801-428-3402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10836743-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical