Individual
DEREK LIVINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
11075 STATE ST #35, SANDY, UT 84070
(801) 990-4300
Mailing address
11075 S STATE ST STE 35, SANDY, UT 84070-5187
(801) 990-4300
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10838570-6009
UT
Other
Enumeration date
06/27/2018
Last updated
01/26/2024
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