Provider Demographics
NPI:1760898571
Name:CELLA, ANGIE (LMFT)
Entity Type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:CELLA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 N EAST PROMONTORY DR.
Mailing Address - Street 2:STE 200
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-7048
Mailing Address - Country:US
Mailing Address - Phone:801-645-0500
Mailing Address - Fax:
Practice Address - Street 1:240 N EAST PROMONTORY DR
Practice Address - Street 2:STE 200
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-7048
Practice Address - Country:US
Practice Address - Phone:801-645-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT352261-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist