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Individual

BRIAN DOUGLAS MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
92 LODESTONE WAY, TOOELE, UT 84074-8050
(435) 833-1900
Mailing address
92 LODESTONE WAY, TOOELE, UT 84074-8050
(435) 833-1900

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
544087
UT

Other

Enumeration date
12/12/2022
Last updated
12/12/2022
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