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General NPI Number Information
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NPI Number | 1306273164
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Entity Type | Individual
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Provider Name | BOE DANIEL EBY A.C.M.H.C
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Gender | Male
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Dates
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Enumeration Date | 10/10/2013
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 7105 S HIGHLAND DR STE 200
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City | COTTONWOOD HEIGHTS
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State | UT
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Zip | 84121-7311
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Country | US
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Telephone | 801-913-5346
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Fax |
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Provider Business Mailing Address
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Address Line | 7244 W FLAXTON LN
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City | WEST JORDAN
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State | UT
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Zip | 84081-5759
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Country | US
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Telephone | 801-913-5346
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5069670-6009
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License Number State | UT
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