Individual
CLINTON RICHARD CHIDESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
96 NORTH 500 WEST, BOUNTIFUL, UT 74010-2840
(801) 698-8755
Mailing address
790 EAST 550 NORTH, BOUNTIFUL, UT 84010-2840
(801) 698-8755
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1121493902
UT
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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