Brent E Crane

Individual provider Active NPI Marriage & Family Therapist · Roosevelt, UT

NPI 1407175151 · NPPES record last updated May 20, 2010

Key facts

NPI
1407175151
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
5206563-3902 (UT)
Practice address
RR 1 Box 1548
Roosevelt, UT 84066-9738
Phone
(435) 722-5656
NPI assigned
May 20, 2010
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

State licenses

LicenseStateTypeSpecialty
5206563-3902UTMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 5206563-3902 UT Yes

Addresses

Primary practice location

RR 1 Box 1548
Roosevelt, UT 84066-9738

Mailing address

RR 1 Box 1548
Roosevelt, UT 84066-9738
Phone (435) 722-5656

Other providers in Roosevelt, UT

All providers in Roosevelt, UT · Marriage & Family Therapist in Utah

Sources for this page

Verify at the official NPI Registry.