Individual
MR. MARK WILLIAM ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., M.F.T.
Contact information
Practice address
500 S. 580 W., ESCALANTE, UT 84726
(702) 541-0061
Mailing address
PO BOX 573, ESCALANTE, UT 84726-0573
(702) 722-9870
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
01235
NV
106H00000X
Marriage & Family Therapist
Primary
7472928-3902
UT
Other
Enumeration date
04/11/2013
Last updated
02/04/2014
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