Individual
MR. SAM LESLIE FARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
411 N GRANT ST, SALT LAKE CITY, UT 84116-2725
(801) 359-8862
Mailing address
411 N GRANT ST, PO BOX 16508, SALT LAKE CITY, UT 84116-2725
(801) 359-8862
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6016166-6004
UT
Other
Enumeration date
02/05/2007
Last updated
04/01/2014
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