Taylor Cameron Herrin, LMFT

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

NPI 1487933909 · NPPES record last updated Aug 15, 2011

Key facts

NPI
1487933909
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
6784539-3902 (UT)
Practice address
5149 S 1500 W
Riverdale, UT 84405-3926
Phone
(801) 475-0402
Fax
(801) 475-7464
NPI assigned
Aug 15, 2011
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
6784539-3902UTMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 6784539-3902 UT Yes

Addresses

Primary practice location

5149 S 1500 W
Riverdale, UT 84405-3926

Mailing address

120 S Sam Gates Rd
Ogden, UT 84404-4773
Phone (801) 475-0402

Other providers in Riverdale, UT

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

Sources for this page

Verify at the official NPI Registry.