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Individual

MICHAEL M. HADERLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
233 S. PLEASANT GROVE BLVD, SUITE 203, PLEASANT GROVE, UT 84062
(801) 785-4622
(801) 785-4623
Mailing address
233 S. PLEASANT GROVE BLVD, SUITE 203, PLEASANT GROVE, UT 84062
(801) 785-4622
(801) 785-4623

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8097827-2501
UT

Other

Enumeration date
09/13/2013
Last updated
09/13/2013
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