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Individual

MR. BRIAN CALVIN BEISTLINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
240 N EAST PROMONTORY, SUITE 200, FARMINGTON, UT 84025-7048
(801) 824-5210
Mailing address
240 N EAST PROMONTORY, SUITE 200, FARMINGTON, UT 84025-7048
(801) 824-5210

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
876000308007
UT
Enumeration date
05/21/2012
Last updated
10/02/2015
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