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General NPI Number Information
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NPI Number | 1356653109
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Entity Type | Individual
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Provider Name | JOSEPH DANIEL TSCHUDY MFT
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Gender | Male
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 07/09/2010
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Provider Practice Location Address
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Address Line | 5150 S WASHINGTON BLVD SUITE 1
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City | SOUTH OGDEN
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State | UT
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Zip | 84405-4506
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Country | US
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Telephone | 801-337-0067
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Fax | 801-337-0070
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Provider Business Mailing Address
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Address Line | 4701 BURCH CREEK DR
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City | OGDEN
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State | UT
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Zip | 84403-4123
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Country | US
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Telephone | 801-710-8301
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 77058603904
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License Number State | UT
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