Provider Demographics
NPI:1548091259
Name:DOCCHIO, CAMI (MBE, ACMHC)
Entity type:Individual
Prefix:
First Name:CAMI
Middle Name:
Last Name:DOCCHIO
Suffix:
Gender:F
Credentials:MBE, ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 N NOCTURNE DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84116-1735
Mailing Address - Country:US
Mailing Address - Phone:484-792-1192
Mailing Address - Fax:
Practice Address - Street 1:4516 S 700 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-4192
Practice Address - Country:US
Practice Address - Phone:385-293-1902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13977362-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health