Individual
MR. TY R. MANSFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MMFT, LMFT
Contact information
Practice address
667 N 1890 W, PROVO, UT 84601-1326
(801) 272-3420
Mailing address
667 N 1890 W, PROVO, UT 84601-1326
(801) 272-3420
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
9808828-3902
UT
Other
Enumeration date
06/09/2010
Last updated
06/06/2016
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