Individual
MR. BRODY KENT BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
1431 S 550 E # 6, OREM, UT 84097-7719
(801) 318-4721
Mailing address
1822 W 795 S, OREM, UT 84058-5026
(801) 318-4721
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9668264-6004
UT
101YM0800X
Mental Health Counselor
9668264-6009
UT
Other
Enumeration date
05/16/2016
Last updated
05/16/2019
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