| Mountain View Family Therapy Llc | |
|
1273 W 12600 S Ste 403 Riverton UT 84065-7111 | |
| (801) 930-0411 | |
| Not Available |
| Full Name | Mountain View Family Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1273 W 12600 S Ste 403, Riverton, Utah |
| Authorized Official Name and Position | Tracie Penunuri (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 8019300411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain View Family Therapy Llc 1273 W 12600 S Ste 403 Riverton UT 84065-7111 Ph: (801) 930-0411 | Mountain View Family Therapy Llc 1273 W 12600 S Ste 403 Riverton UT 84065-7111 Ph: (801) 930-0411 |
| NPI Number | 1790266682 |
|---|---|
| Provider Enumeration Date | 08/28/2018 |
| Last Update Date | 11/16/2019 |
| Medicare PECOS PAC ID | 7214361666 |
|---|---|
| Medicare Enrollment ID | O20191218001633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790266682 | NPI | - | NPPES |
| Provider Name | Tracie Elaine Penunuri |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245666106 PECOS PAC ID: 0446482244 Enrollment ID: I20140409001955 |
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