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Individual

MATTHEW JOSEPH VICARIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CMHC

Contact information

Practice address
4055 S 700 E STE 204, SALT LAKE CITY, UT 84107-2504
(801) 946-2323
Mailing address
4760 S WOODDUCK LN, SALT LAKE CITY, UT 84117-4935
(801) 946-2323

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5170621-6004
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1235447772
UT
Enumeration date
11/11/2010
Last updated
09/16/2021
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