Basic Information
| Provider Information | |||||||||
| NPI: | 1487136057 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EEKHOFF | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | RENAE | ||||||||
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| Credential: | MS, LCGC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5121 S COTTONWOOD ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | MURRAY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841075701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015077400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5121 S COTTONWOOD ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | MURRAY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841075701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015077400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2018 | ||||||||
| LastUpdateDate: | 08/30/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 170300000X | 10896220-3602 | UT | Y | Other Service Providers | Genetic Counselor, MS |
No ID Information.