Organization Name: | ALLIANCE CLINICAL SERVICES, LLP |
NPI Number: | 1093985038 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CLARISSE CHADWICK (PARTNER/THERAPIST) |
Mailing Address: | 175 N Main St Ste B1 Heber City |
State: | UT US |
Postal Code: | 840321668 |
Phone Number: | 4356579588 |
Fax Number: | 4356579588 |
NPI Enumeration Date: | 03/05/2008 |
NPI Last Update Date: | 03/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |