Individual
MICHAEL DEAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1222
(801) 583-2500
Mailing address
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1222
(801) 583-2500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
11050369-3501
UT
Other
Enumeration date
09/13/2016
Last updated
03/06/2024
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