Individual
DANIEL THOMAS HAYCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
715 E 3900 S STE 109, SALT LAKE CITY, UT 84107
(801) 878-0190
Mailing address
715 E 3900 S STE 109, SALT LAKE CITY, UT 84107-2568
(801) 878-0190
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
11251842-3502
UT
Other
Enumeration date
08/13/2018
Last updated
07/03/2019
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