Provider Demographics
NPI:1932720083
Name:LECHEMINANT, MADELINE COOPER
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:COOPER
Last Name:LECHEMINANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 E 850 S
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-2526
Mailing Address - Country:US
Mailing Address - Phone:801-349-5993
Mailing Address - Fax:
Practice Address - Street 1:430 E 450 S
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-1736
Practice Address - Country:US
Practice Address - Phone:801-776-3305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker