Provider Demographics
NPI:1780115394
Name:PALMER, ANNA SOPHIA (MA CMHC NCC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:SOPHIA
Last Name:PALMER
Suffix:
Gender:F
Credentials:MA CMHC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 W 1065 S
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-3517
Mailing Address - Country:US
Mailing Address - Phone:801-602-9493
Mailing Address - Fax:
Practice Address - Street 1:815 W 450 S
Practice Address - Street 2:SUITE #110
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-2200
Practice Address - Country:US
Practice Address - Phone:801-477-4084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9832716-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health