Individual
MR. MICHAEL K. FILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
625 E 8400 S, SANDY, UT 84070-0525
(801) 566-2556
(801) 566-2639
Mailing address
625 E 8400 S, SANDY, UT 84070-0525
(801) 566-2556
(801) 566-2639
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4800488-3501
UT
Other
Enumeration date
10/03/2006
Last updated
05/04/2011
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