Organization
TRACEY DWYER MARRIAGE AND FAMILY THERAPIST INC.
Active
Other names
Tracey Dwyer Marriage and Family Therapist Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY ANNE DWYER LMFT (OWNER)
(354) 800-9192
Entity
Organization
Contact information
Practice address
3022 LOWER SADDLEBACK RD, PARK CITY, UT 84098-4850
(800) 435-9192
Mailing address
PO BOX 980301, PARK CITY, UT 84098-0301
(435) 800-9192
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12229368-0142
CORPORATE ID
UT
Enumeration date
05/07/2021
Last updated
05/07/2021
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