Individual
DOLORES MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
274 N MAIN ST, LOGAN, UT 84321-3915
(435) 881-0584
Mailing address
560 W 465 N STE 604, PROVIDENCE, UT 84332-8006
(435) 753-1600
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
9037739-3902
UT
Other
Enumeration date
10/13/2016
Last updated
08/16/2021
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