Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 349328-6004 | UT |
NPI | 1003147745 |
---|---|
Provider Name | Michelle Ashby Cherry |
First Address | Eden, UT 84310-1091 |
Second Address | Eden, UT 84310-1091 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2010 |
Last Update Date | 07/10/2011 |