Provider Demographics
NPI:1245626357
Name:SUNLIGHT FAMILY THERAPY
Entity type:Organization
Organization Name:SUNLIGHT FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOLDING
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:801-541-7815
Mailing Address - Street 1:4061 S MOUNT OLYMPUS WAY
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-2317
Mailing Address - Country:US
Mailing Address - Phone:801-274-2718
Mailing Address - Fax:
Practice Address - Street 1:4505 S WASATCH BLVD
Practice Address - Street 2:SUITE 190
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-4709
Practice Address - Country:US
Practice Address - Phone:801-541-7815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8317552-3902251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health