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Individual

DAVID R VISSER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CMHC

Contact information

Practice address
237 26TH ST, OGDEN, UT 84401
(801) 778-6840
Mailing address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000055266
MEDICARE PIN
UT
01
260022408
RAILROAD MEDICARE
UT
05
876003009007
UT
Enumeration date
11/02/2011
Last updated
06/18/2018
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