Individual
NATHAN HASLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
636 E ROOSEVELT AVE, SALT LAKE CITY, UT 84105-2121
(801) 644-6367
Mailing address
636 E ROOSEVELT AVE, SALT LAKE CITY, UT 84105-2121
(801) 644-6367
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4892548-6004
UT
Other
Enumeration date
11/06/2020
Last updated
08/15/2022
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