Provider Demographics
NPI:1891181863
Name:TROTTER, ANDREW (CMHC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:TROTTER
Suffix:
Gender:M
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2659 S 1500 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-3534
Mailing Address - Country:US
Mailing Address - Phone:801-673-0559
Mailing Address - Fax:801-384-0557
Practice Address - Street 1:2670 S 2000 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-1782
Practice Address - Country:US
Practice Address - Phone:801-673-0559
Practice Address - Fax:801-384-0557
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6245293-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health