Individual
MICHELLE MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACMHC
Contact information
Practice address
494 EAST 2400 NORTH, TOOELE, UT 84074
(435) 249-0321
(432) 249-0360
Mailing address
494 EAST 2400 NORTH, STE B, TOOELE, UT 84074
(435) 249-0321
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1932166980
UT
Other
Enumeration date
12/01/2011
Last updated
05/26/2015
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