Individual
MR. DONAVAN DANIEL FAUCETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
90 E 200 N, LOGAN, UT 84321-4034
(435) 752-0750
Mailing address
30 W 100 N, HYRUM, UT 84319-1214
(435) 764-2386
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6729778-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876000308007
—
UT
Enumeration date
04/23/2007
Last updated
08/25/2009
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