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Individual

MARK CHAMBERLAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
285 W 800 S, ROOSEVELT, UT 84066-3707
(435) 725-6300
(435) 725-6325
Mailing address
1087 W 100 S, LAYTON, UT 84041-5266
(435) 725-6300
(435) 725-6325

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
317549-2501
UT

Other

Enumeration date
08/28/2007
Last updated
08/28/2007
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