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1376022103
DANIEL THOMAS HAYCOCK
SALT LAKE CITY, UT
NPI
1376022103
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 11251842-3502)
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2018-08-13
Last Update Date
2019-07-03
Business Address
DANIEL THOMAS HAYCOCK
715 E 3900 S STE 109
SALT LAKE CITY, UT 84107
Phone number: 801-878-0190
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Mailing Address
DANIEL THOMAS HAYCOCK
715 E 3900 S STE 109
SALT LAKE CITY, UT 84107-2568
Phone number: 801-878-0190
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