Provider Demographics
NPI:1346052396
Name:ANGELI, NATALEE (LSUDC)
Entity type:Individual
Prefix:
First Name:NATALEE
Middle Name:
Last Name:ANGELI
Suffix:
Gender:F
Credentials:LSUDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5722 N ABERDEEN LN
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-9667
Mailing Address - Country:US
Mailing Address - Phone:435-241-2819
Mailing Address - Fax:
Practice Address - Street 1:7181 S CAMPUS VIEW DR STE 1A
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-4312
Practice Address - Country:US
Practice Address - Phone:801-613-9843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12896567-6006101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)