Individual
MARIAH BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAMFT
Contact information
Practice address
5965 S 900 E, SALT LAKE CITY, UT 84121-1720
(801) 263-7138
Mailing address
5965 S 900 E, SALT LAKE CITY, UT 84121-1720
(801) 263-7138
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
9301561-3904
UT
Other
Enumeration date
04/28/2015
Last updated
09/02/2015
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