Radiant Moon, Pllc

NPI #1811651938 in Midvale, Utah

Provider Information

NPI Number: 1811651938
Entity Type: Organization
Organization Name: Radiant Moon, Pllc
Primary Specialty: Counselor - Mental Health
Enumeration Date: Oct 25, 2021
Last Updated: Dec 19, 2023

Practice Location

Address: 940 E SOUTH UNION AVE
City: Midvale
State: Utah
ZIP Code: 84047-2302
Phone: (385) 346-0031

Authorized Official

Name: MRS. KATHRYN WINGARD, LCMHC, ATR-BC
Title: OWNER/CLINICAL DIRECTOR
Phone: (385) 346-0031

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Art Therapist	221700000X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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