Doctor Name: | TAMARA OLLERTON |
NPI Number: | 1619374063 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, SCMT, MT-BC |
License Number: | 9154068-4010 |
Business Practice Address: | 2450 E Ellisonwoods Ave Cottonwood Heights, UT - 841212652 |
Business Phone Number: | 8018675798 |
Business Fax Number: | |
Mailing Address: | 2450 E Ellisonwoods Ave, COTTONWOOD HEIGHTS |
State: | UT |
Postal Code: | 841212652 |
Phone Number: | 8018675798 |
Fax Number: | |
NPI Enumeration Date: | 12/01/2014 |
NPI Last Update Date: | 12/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 9154068-4010 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |