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Individual

MR. MACHIEL PIETER KLERK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
2010 EVERGREEN AVE, SALT LAKE CITY, UT 84109-2923
(801) 656-8806
Mailing address
150 S 600 E STE 7C, SALT LAKE CITY, UT 84102-1989
(801) 656-8806

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
6938635-3902
UT

Other

Enumeration date
12/07/2010
Last updated
12/07/2010
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