Organization
STAGES FAMILY THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK WILLIS HAGEY PHD (CO-OWNER)
(801) 200-2506
Entity
Organization
Contact information
Practice address
4095 E PONY EXPRESS PKWY STE 15, EAGLE MOUNTAIN, UT 84005-5529
(801) 200-2506
Mailing address
2039 E FICUS WAY, EAGLE MTN, UT 84005-5741
(801) 200-2506
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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