| Transformative Care | |
|
4055 S 700 E Ste 102f Salt Lake City UT 84107-2174 | |
| (801) 618-0852 | |
| Not Available |
| Full Name | Transformative Care |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 4055 S 700 E Ste 102f, Salt Lake City, Utah |
| Authorized Official Name and Position | Jamie Leigh Bustamante (PSYCHOLOGIST) |
| Authorized Official Contact | 8016180852 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformative Care 1187 E Charlton Ave Salt Lake City UT 84106-2603 Ph: (928) 607-4677 | Transformative Care 4055 S 700 E Ste 102f Salt Lake City UT 84107-2174 Ph: (801) 618-0852 |
| NPI Number | 1649891953 |
|---|---|
| Provider Enumeration Date | 04/28/2020 |
| Last Update Date | 04/28/2020 |
| Certification Date | 04/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649891953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
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