Individual
MICHAELA SOFIA HIGASHIYAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2850 N 2000 W STE 101, FARR WEST, UT 84404-9230
(801) 528-5095
(801) 528-5094
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14235706-3501
UT
1041C0700X
Clinical Social Worker
BBH-LCSW-LIC-72295
MT
Other
Enumeration date
07/26/2024
Last updated
07/29/2025
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