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Organization
STATION PARK COUNSELING
Active
Organization
STATION PARK COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN BESITLINE (LMFT)
(801) 824-5210
Entity
Organization
Contact information
Practice address
240 N EAST PROMONTORY, 200, FARMINGTON, UT 84025-2950
(801) 907-1095
Mailing address
240 N EAST PROMONTORY, 200, FARMINGTON, UT 84025-2950
(801) 907-1095
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
8677094-3902
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13639489
CAQH
UT
Enumeration date
01/12/2016
Last updated
01/12/2016
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