Individual
MICKEL SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
3611 S CAMINO REAL, WASHINGTON, UT 84780-8396
(435) 900-7455
Mailing address
3611 S CAMINO REAL, WASHINGTON, UT 84780-8396
(435) 900-7455
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
13982725-3102
UT
Other
Enumeration date
09/16/2025
Last updated
09/16/2025
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