| Affect Provider Group P.s.c. | |
|
10 W Broadway Fl 7 Salt Lake City UT 84101-2060 | |
| (845) 769-8758 | |
| Not Available |
| Full Name | Affect Provider Group P.s.c. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 10 W Broadway Fl 7, Salt Lake City, Utah |
| Authorized Official Name and Position | Karla Renee Mullings (DIRECTOR OF COMPLIANCE) |
| Authorized Official Contact | 8457688758 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Affect Provider Group P.s.c. 1640 Boro Pl Fl 4 Mc Lean VA 22102-3627 Ph: (845) 769-8758 | Affect Provider Group P.s.c. 10 W Broadway Fl 7 Salt Lake City UT 84101-2060 Ph: (845) 769-8758 |
| NPI Number | 1417849548 |
|---|---|
| Provider Enumeration Date | 07/15/2025 |
| Last Update Date | 07/15/2025 |
| Certification Date | 07/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417849548 | NPI | - | NPPES |
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