Individual
BRIGHAM YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1190 N 900 E STE 204, PROVO, UT 84604-3536
(801) 422-7620
(801) 422-0165
Mailing address
1190 N 900 E STE 204, PROVO, UT 84604-3536
(801) 422-7620
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
138479-3501
UT
Other
Enumeration date
05/07/2014
Last updated
05/07/2014
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