Individual
AMMON KC FAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1045 8TH AVE NW, BYRON, MN 55920-1590
(801) 603-9880
Mailing address
102 COLLEGE AVE, DURHAM, NC 27713-6032
(801) 648-9742
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
8375045-3902
UT
Other
Enumeration date
12/19/2011
Last updated
05/01/2024
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