Provider Demographics
NPI:1437464872
Name:HOTTON, CHARITY D (SSW, INTERN, AMFT)
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:D
Last Name:HOTTON
Suffix:
Gender:F
Credentials:SSW, INTERN, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6228 W HERITAGE HILL DR
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-6973
Mailing Address - Country:US
Mailing Address - Phone:801-557-4482
Mailing Address - Fax:
Practice Address - Street 1:13552 S 110 W STE 204
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020
Practice Address - Country:US
Practice Address - Phone:801-432-0883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5338218-3503104100000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker