Gregory Hatch Fowers, MFT

Individual provider Active NPI Marriage & Family Therapist · North Logan, UT

NPI 1275816639 · NPPES record last updated Sep 22, 2011

Key facts

NPI
1275816639
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
8098373-3904 (UT)
Practice address
2072 N Main St Ste 101
North Logan, UT 84341-1778
Phone
(435) 752-4646
NPI assigned
Sep 22, 2011
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8098373-3904UTMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 8098373-3904 UT Yes

Addresses

Primary practice location

2072 N Main St Ste 101
North Logan, UT 84341-1778

Mailing address

2072 N Main St Ste 101
North Logan, UT 84341-1778
Phone (435) 752-4646

Other providers in North Logan, UT

All providers in North Logan, UT · Marriage & Family Therapist in Utah

Sources for this page

Verify at the official NPI Registry.