RADIANT MOON PLLC NPI 1811651938

NPI Information

RADIANT MOON, PLLC is a mental health counselor in Midvale, UT. RADIANT MOON, PLLC NPI is 1811651938. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Kathryn Wingard Creative Counseling.

The provider's business location address is:

940 E SOUTH UNION AVE
MIDVALE, UT
ZIP 84047-302
Phone: (385) 346-0031
Fax: (385) 446-0973

The provider's authorized official is Kathryn Wingard .
The authorized official title is Owner/clinical Director and has the following contact phone number (385) 346-0031.

The enumeration date for this NPI number is 10/25/2021 and was last updated on 12/19/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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