Organization
SAM AND RAGAN LLP
Active
Other names
Gumtree Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL RYLAND LCSW (PARTNER)
(801) 228-0606
Entity
Organization
Contact information
Practice address
1 E CENTER ST STE 300, PROVO, UT 84606-3154
(801) 332-9660
Mailing address
1356 S 2770 E, SPANISH FORK, UT 84660-9403
(801) 228-0606
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
01/28/2022
Last updated
12/09/2022
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