Provider Demographics
NPI:1639213432
Name:PALUMBOS, JANICE C (CGC, LGC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:C
Last Name:PALUMBOS
Suffix:
Gender:F
Credentials:CGC, LGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2085 EAST 3070 SOUTH
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-2426
Mailing Address - Country:US
Mailing Address - Phone:801-487-6491
Mailing Address - Fax:
Practice Address - Street 1:2C412 SOM
Practice Address - Street 2:50 N. MEDICAL DRIVE
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132
Practice Address - Country:US
Practice Address - Phone:801-581-6935
Practice Address - Fax:801-585-7252
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT51056693601170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS