Provider Demographics
NPI:1801634142
Name:A CHILD'S HOPEFUL JOURNEY
Entity type:Organization
Organization Name:A CHILD'S HOPEFUL JOURNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:H
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:435-817-9880
Mailing Address - Street 1:2639 S 4010 W
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737-7766
Mailing Address - Country:US
Mailing Address - Phone:435-680-2681
Mailing Address - Fax:
Practice Address - Street 1:169 W 2710 SOUTH CIR STE 203F
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7251
Practice Address - Country:US
Practice Address - Phone:435-817-9880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty