Organization · Type 2 NPI
Wild Expanse Counseling PLLC
Adult Mental Health Clinic/Center · Salt Lake City, UT
NPI number
1245029792
Active
Practice location
1518 S 1100 E Ste B
Salt Lake City, UT 84105-2579
Mailing address
1074 1/2 E Kensington Ave
Salt Lake City, UT 84105-2404
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Mental Health Clinic/Center Primary | 261QM0850X | None listed |
Adult Mental Health Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
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About NPI 1245029792
Wild Expanse Counseling PLLC's National Provider Identifier is 1245029792, issued on May 1, 2025. The primary taxonomy on file is Adult Mental Health Clinic/Center (261QM0850X), and the practice location is in Salt Lake City, UT. The record was last updated on May 1, 2025.