Organization
WISE MIND ONLINE THERAPY
Active
Other names
Wise Mind Online Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRAVIS REED STEPHENS LCSW (OWNER / SHARE HOLDER)
(208) 243-3332
Entity
Organization
Contact information
Practice address
915 N 510 E, OREM, UT 84097-3374
(208) 243-3332
Mailing address
915 N 510 E, OREM, UT 84097-3374
(208) 243-3332
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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