Basic Information
| Provider Information | |||||||||
| NPI: | 1922300060 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DREW | ||||||||
| FirstName: | CLAUDIA | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | CPCI | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 900245 | ||||||||
| Address2: | |||||||||
| City: | SANDY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840900245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8016348727 | ||||||||
| FaxNumber: | 8017334083 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 E MAIN ST STE M | ||||||||
| Address2: | |||||||||
| City: | GRANTSVILLE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840299031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8016348727 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2010 | ||||||||
| LastUpdateDate: | 11/22/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 6982290-6009 | UT | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.