Provider Demographics
NPI:1689296352
Name:MCLAWS, CHRISTINE (AMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MCLAWS
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:CHRISTINE
Other - Last Name:MCLAWS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 583
Mailing Address - Street 2:
Mailing Address - City:KAMAS
Mailing Address - State:UT
Mailing Address - Zip Code:84036-0583
Mailing Address - Country:US
Mailing Address - Phone:435-513-1500
Mailing Address - Fax:
Practice Address - Street 1:425 E 1200 S STE L4
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-4607
Practice Address - Country:US
Practice Address - Phone:435-513-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-15
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5508523-3903101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT5508523-3904OtherDOPL