Healthcare Provider Details

I. General information

NPI: 1437475118
Provider Name (Legal Business Name): DONALD ROY BRIGGS LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 04/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E 4500 S STE 260
MURRAY UT
84107-3954
US

IV. Provider business mailing address

345 E 4500 S STE 260
MURRAY UT
84107-3954
US

V. Phone/Fax

Practice location:
  • Phone: 801-747-3556
  • Fax: 801-747-2086
Mailing address:
  • Phone: 801-747-3556
  • Fax: 801-747-2086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5076247-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: