| Queer Family Therapy, Pllc | |
|
288 W Center St Provo UT 84601-4419 | |
| (509) 521-1536 | |
| Not Available |
| Full Name | Queer Family Therapy, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 288 W Center St, Provo, Utah |
| Authorized Official Name and Position | Lacey Bagley (OWNER) |
| Authorized Official Contact | 5095211536 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Queer Family Therapy, Pllc 712 Utah Ave Provo UT 84606-5217 Ph: () - | Queer Family Therapy, Pllc 288 W Center St Provo UT 84601-4419 Ph: (509) 521-1536 |
| NPI Number | 1013809680 |
|---|---|
| Provider Enumeration Date | 07/17/2025 |
| Last Update Date | 07/17/2025 |
| Certification Date | 07/17/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013809680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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