Individual
DOUGLAS RAY STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
411 GRANT ST, SALT LAKE CITY, UT 84116-2725
(801) 359-8862
Mailing address
9704 S 2760 E, SANDY, UT 84092-3411
(801) 942-4970
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
27743846004
UT
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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