Provider Demographics
NPI:1740415942
Name:DRAPER, CORINNE W (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:W
Last Name:DRAPER
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N MALL DR STE I102
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7322
Mailing Address - Country:US
Mailing Address - Phone:435-619-9441
Mailing Address - Fax:
Practice Address - Street 1:321 N MALL DR STE I102
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7322
Practice Address - Country:US
Practice Address - Phone:435-619-9441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3116693902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist