Chrysalis Utah, Inc.

NPI #1356843114 in Provo, Utah

Provider Information

NPI Number: 1356843114
Entity Type: Organization
Organization Name: Chrysalis Utah, Inc.
Subpart: Yes (part of a larger organization)
Parent Organization: CHRYSALIS UTAH, INC.
Primary Specialty: Counselor - Mental Health
Enumeration Date: Mar 7, 2018
Last Updated: Mar 7, 2018

Practice Location

Address: 1507 S 180 E
City: Provo
State: Utah
ZIP Code: 84606-5570
Phone: (801) 426-6661

Authorized Official

Name: RICHARD SLACK
Title: CFO
Phone: (801) 655-4950

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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