| Circle Treatment | |
|
312 S Main St Tooele UT 84074-2746 | |
| (435) 841-9177 | |
| (435) 882-7330 |
| Full Name | Circle Treatment |
|---|---|
| Speciality | Social Worker |
| Location | 312 S Main St, Tooele, Utah |
| Authorized Official Name and Position | Molly G Prince (OWNER, THERAPIST) |
| Authorized Official Contact | 8016804705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Circle Treatment 432 Cleveland Ave Salt Lake City UT 84115-1510 Ph: (435) 841-9177 | Circle Treatment 312 S Main St Tooele UT 84074-2746 Ph: (435) 841-9177 |
| NPI Number | 1700012192 |
|---|---|
| Provider Enumeration Date | 05/31/2009 |
| Last Update Date | 02/27/2010 |
| Medicare PECOS PAC ID | 9133263767 |
|---|---|
| Medicare Enrollment ID | O20100220000418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700012192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3332853501 (Utah) | Primary |
| Provider Name | Molly G Prince |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396700548 PECOS PAC ID: 8022177807 Enrollment ID: I20081107000619 |
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