Provider Demographics
NPI:1760147821
Name:WHETTEN, SUELEN
Entity Type:Individual
Prefix:
First Name:SUELEN
Middle Name:
Last Name:WHETTEN
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 1:149 N 1200 E STE 110
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-2247
Mailing Address - Country:US
Mailing Address - Phone:385-287-0555
Mailing Address - Fax:
Practice Address - Street 1:149 N 1200 E STE 110
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-2247
Practice Address - Country:US
Practice Address - Phone:385-287-0555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical