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Organization

PINE FOREST COUNSELING, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DYLAN MATSUMORI PH.D. (PSYCHOLOGIST)
(435) 319-0995
Entity
Organization

Contact information

Practice address
1031 S BLUFF ST, SAINT GEORGE, UT 84770-5206
(435) 319-0995
Mailing address
1031 S BLUFF ST, SAINT GEORGE, UT 84770-5206
(435) 319-0995

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
9133425-2501
UT

Other

Enumeration date
03/27/2015
Last updated
03/27/2015
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