Individual
MR. MICHAEL TED BOMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3564 S 7200 W, MAGNA, UT 84044-3507
(801) 250-2909
(801) 252-0444
Mailing address
3564 S 7200 W, MAGNA, UT 84044-3507
(801) 250-2909
(801) 252-0444
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
373112-3501
UT
Other
Enumeration date
04/03/2006
Last updated
07/08/2007
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