Provider Demographics
NPI:1346806403
Name:MOENCH-PARENT, JULIA CARROLL (ACMHC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:CARROLL
Last Name:MOENCH-PARENT
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7628 S RIVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84093-6134
Mailing Address - Country:US
Mailing Address - Phone:801-750-1533
Mailing Address - Fax:
Practice Address - Street 1:8375 S 700 E
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-0504
Practice Address - Country:US
Practice Address - Phone:801-981-8702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10444864-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health