Individual
MR. JOHN ELLIS BODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1258 W SOUTH JORDAN PKWY, SUITE 202, SOUTH JORDAN, UT 84095-4711
(801) 255-1155
Mailing address
PO BOX 694, AMERICAN FORK, UT 84003-0694
(801) 400-0734
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5006522-6004
UT
Other
Enumeration date
07/17/2006
Last updated
05/13/2010
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