Most Relevant Information
Provider Data
| NPI Number: | 1003573338 |
| Provider Name: | COURTNEY VANDERMYDEN |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/22/2021 |
| Last Updated: | 11/22/2021 |
Provider Practice Location
2655 S LAKE ERIE DR
WEST VALLEY
UT
841207350
Practice Location Phone/Fax
| Phone: | 3854414900 |
| Fax: |
Provider Mailing Location
4866 W DIAMONDLEAF WAY
WEST JORDAN
UT
840814759
Provider Mailing Phone/Fax
| Phone: | 9167121148 |
| Fax: |