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NPI 1427484617

NPI 1427484617 : JOSHUA VEILLON-KHAMMUAN : OGDEN, UT

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General NPI Number Information
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    NPI Number           |    1427484617
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    Entity Type          |    Individual 
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    Provider Name        |    JOSHUA VEILLON-KHAMMUAN
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/19/2013
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    Last Update Date     |    09/19/2013
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Provider Practice Location Address
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    Address Line         |    3156 HARRISON BLVD 
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    City                 |    OGDEN
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    State                |    UT
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    Zip                  |    84403-0827
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    Country              |    US
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    Telephone            |    435-553-8013
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3156 HARRISON BLVD 
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    City                 |    OGDEN
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    State                |    UT
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    Zip                  |    84403-0827
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    Country              |    US
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    Telephone            |    
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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        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    
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    License Number State |    
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