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1386624625
DEREK PAUL DAVIS
PROVO, UT
NPI
1386624625
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 139877-3501)
Enumeration Date
2006-01-20
Last Update Date
2019-06-28
Business Address
Mr. DEREK PAUL DAVIS LCSW
1300 E CENTER ST
PROVO, UT 84606-3554
Phone number: 801-344-4215
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Mailing Address
Mr. DEREK PAUL DAVIS LCSW
PO BOX 270
PROVO, UT 84603-0270
Phone number: 801-344-4400
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