Mallory R Sdano, MS, LCGC

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

8118447-3601 Issued in UT

Practice address

423 S Wakara Way
Suite 200
Salt Lake City, UT 84108-1242

Phone

(801) 931-6228

NPI assigned

Jan 7, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1376880682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 S WAKARA WAY",
            "address_2": "SUITE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 S WAKARA WAY",
            "address_2": "SUITE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081242",
            "telephone_number": "801-931-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SDANO",
        "first_name": "MALLORY",
        "middle_name": "R",
        "credential": "MS, LCGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "UT",
            "license": "8118447-3601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENETIC COUNSELING LICENSE",
            "identifier": "8118447-3601",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Genetic Counselor (M.S.) in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Genetic Counselor (M.S.) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.