Individual
PROF. MICHAEL READ FORDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
501 CHIPETA WAY, SUITE 1250, SALT LAKE CITY, UT 84108-1222
(801) 587-3208
(801) 585-8410
Mailing address
501 CHIPETA WAY, SUITE 1250, SALT LAKE CITY, UT 84108-1222
(801) 587-3208
(801) 585-8410
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
105393-2501
UT
Other
Enumeration date
09/28/2006
Last updated
09/24/2008
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