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Individual

MYLES DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
340 E 100 S, SALT LAKE CITY, UT 84111-1702
(801) 322-4257
Mailing address
5814 S 900 E, MURRAY, UT 84121-1644
(385) 800-3272
(385) 800-3260

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary
9438804-3501
UT

Other

Enumeration date
01/17/2012
Last updated
10/11/2019
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