Individual
PARKER KEONI ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ASUDC
Contact information
Practice address
1904 W GORDON AVE, LAYTON, UT 84041-7232
(801) 444-0794
Mailing address
1904 W GORDON AVE, LAYTON, UT 84041-7232
(801) 444-0794
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5894886-6006
UT
Other
Enumeration date
08/06/2014
Last updated
08/06/2014
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