Individual
DR. MITCHELL WAYNE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5965 S 900 E, SALT LAKE CITY, UT 84121-1720
(888) 949-4864
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
Primary
9187581-2501
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/08/2011
Last updated
12/13/2018
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