Healthcare Provider Details

I. General information

NPI: 1669783866
Provider Name (Legal Business Name): MICHAEL DON MORGAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 HIGHLAND DR
SALT LAKE CITY UT
84121-1359
US

IV. Provider business mailing address

53 E 740 S
OREM UT
84058-6231
US

V. Phone/Fax

Practice location:
  • Phone: 801-272-9980
  • Fax:
Mailing address:
  • Phone: 801-554-4311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number6153954-3904
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: