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Individual

MR. CAVETT S ISHIHARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MFTI

Contact information

Practice address
350 E 2100 S, SLC, UT 84115
(801) 428-3422
Mailing address
1089 S 2220 W, LEHI, UT 84043
(815) 909-7440

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1992148779
UT

Other

Enumeration date
05/21/2013
Last updated
05/21/2013
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