Organization
MODERN FAMILY THERAPY SERVICES LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLA WILLARD (OWNER)
(801) 896-3284
Entity
Organization
Contact information
Practice address
4933 S 1500 W STE 200, RIVERDALE, UT 84405-7738
(801) 896-3284
Mailing address
5040 S 3300 W, ROY, UT 84067-8666
(801) 896-3284
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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