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1265707038
LUCAS JAMES MOULTON
OREM, UT
NPI
1265707038
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 7126504-3501)
Enumeration Date
2012-03-13
Last Update Date
2012-03-13
Business Address
Mr. LUCAS JAMES MOULTON LCSW, CRC, LVRC
1358 PROVO SLOUGH ACCESS RD
OREM, UT 84058
Phone number: 801-373-1197
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Mailing Address
Mr. LUCAS JAMES MOULTON LCSW, CRC, LVRC
1358 PROVO SLOUGH ACCESS RD
OREM, UT 84058
Phone number: 801-373-1197
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