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Individual

MR. RAYMOND H BURGOYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
433 S 500 E, AMERICAN FORK, UT 84003-2527
(801) 216-8000
(801) 216-8001
Mailing address
343 N 825 E, AMERICAN FORK, UT 84003-1952
(801) 756-4619

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
100789-3501
UT

Other

Enumeration date
07/04/2006
Last updated
07/08/2007
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