Provider Demographics
NPI:1649586538
Name:SUTTON, PATRICIA J
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:SUTTON
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 1:4629 COUNTRY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-3013
Mailing Address - Country:US
Mailing Address - Phone:801-388-6531
Mailing Address - Fax:801-475-4997
Practice Address - Street 1:1140 36TH ST STE 210
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2069
Practice Address - Country:US
Practice Address - Phone:801-388-6531
Practice Address - Fax:801-392-0943
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7747238-6009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional