Individual
MARTIN HARSTON MATHESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5455 RIVER RUN DR, PROVO, UT 84604-7726
(801) 226-2550
(801) 226-8298
Mailing address
5455 RIVER RUN DR, PROVO, UT 84604-7726
(801) 226-2550
(801) 226-8298
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2930773501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005742626
—
UT
Enumeration date
08/24/2006
Last updated
11/19/2009
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