Individual
DR. MARK STEPHEN MANAZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
511 W 200 S, SUITE 160, SALT LAKE CITY, UT 84101-1185
(801) 363-9414
(801) 355-3546
Mailing address
5643 BONICA LN, HERRIMAN, UT 84065-1741
(801) 446-4964
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
380579-2501
UT
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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