Individual
KERRY MAX PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
21 N 490 W, AMERICAN FORK, UT 84003-2264
(801) 592-7876
Mailing address
21 N 490 W, AMERICAN FORK, UT 84003-2264
(801) 592-7876
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
126677-3902
UT
Other
Enumeration date
03/13/2008
Last updated
02/04/2016
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