Individual
MR. DANIEL POULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
32 W WINCHESTER ST, SUITE 101, SALT LAKE CITY, UT 84107-5607
(801) 263-6367
Mailing address
2015 CRYSTAL AVE, SALT LAKE CITY, UT 84109-1704
(801) 631-8147
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6337850
AMERICAN COUNSELING ASSOCIATION
UT
Enumeration date
02/06/2012
Last updated
02/06/2012
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