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Individual

LAYNE TRAVIS MECHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2028 W 500 N STE B, VERNAL, UT 84078-8283
(435) 219-6312
Mailing address
2028 W 500 N STE B, VERNAL, UT 84078-8283
(435) 219-6312

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
104100000X
Social Worker
Primary
12789217-3503
UT
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
01/11/2021
Last updated
04/14/2023
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