Individual
MR. ERIC C FAWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW LCSW
Contact information
Practice address
103 EAST BLUE MEADOW CIRCLE, PANGUITCH, UT 84759-1042
(435) 690-0373
Mailing address
PO BOX 1042, PANGUITCH, UT 84759-1042
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
59138793501
UT
Other
Enumeration date
11/06/2012
Last updated
11/06/2012
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