Damion Archuleta
Individual provider Active NPI Counselor · Brigham City, UT
NPI 1376952028 · NPPES record last updated Aug 7, 2014
Key facts
- NPI
- 1376952028
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 862 N Main Street Suite 4
Brigham City, UT 84302 - Phone
- (435) 723-1799
- NPI assigned
- Aug 7, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
862 N Main Street Suite 4
Brigham City, UT 84302
Mailing address
862 N Main Street Suite 4
Brigham City, UT 84302
Phone (435) 723-1799
Other providers in Brigham City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.