Individual
MR. MICHAEL THOMAS STEVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
979 HOLLYWOOD AVE, SALT LAKE CITY, UT 84105-3347
(801) 582-1565
(801) 584-2507
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
133
MT
Other
Enumeration date
06/28/2006
Last updated
07/08/2007
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