Provider Demographics
NPI:1457794992
Name:GALIETI, KATHERIN BERNICE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KATHERIN
Middle Name:BERNICE
Last Name:GALIETI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 900013
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84090-0013
Mailing Address - Country:US
Mailing Address - Phone:801-733-8770
Mailing Address - Fax:801-733-8773
Practice Address - Street 1:26 IVY OAKS LN
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-2513
Practice Address - Country:US
Practice Address - Phone:801-733-8770
Practice Address - Fax:801-733-8773
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5118632-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health