Individual
MR. TIMOTHY DAVID WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACMHC
Contact information
Practice address
66 S 360 E, AMERICAN FORK, UT 84003-2590
(801) 449-0017
Mailing address
11908 S POWDER CV, HERRIMAN, UT 84096-7738
(801) 792-9236
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5291774-6009
UT
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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