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General NPI Number Information
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NPI Number | 1356685408
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Entity Type | Individual
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Provider Name | MICHAEL S BUXTON PHD, MFT
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Gender | Male
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 11/15/2012
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Provider Practice Location Address
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Address Line | 1500 WSC BYU
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City | PROVO
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State | UT
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Zip | 84602-7924
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Country | US
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Telephone | 801-318-1900
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Fax | 801-422-0173
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Provider Business Mailing Address
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Address Line | 535 E 4500 S D-140
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City | SALT LAKE CITY
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State | UT
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Zip | 84107-2929
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Country | US
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Telephone | 801-288-0747
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Fax | 801-288-0761
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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 | 360148-3902
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License Number State | UT
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