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General NPI Number Information
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NPI Number | 1831866508
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Entity Type | Individual
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Provider Name | CLINTON TWITCHELL MMFT
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Gender | Male
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 1680 EAST, SUITE D-1
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City | ST. GEORGE
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State | UT
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Zip | 84790
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Country | US
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Telephone | 435-705-9571
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Fax |
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Provider Business Mailing Address
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Address Line | 147 N SILVERSPUR DR
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City | CEDAR CITY
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State | UT
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Zip | 84720-2229
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Country | US
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Telephone | 435-592-6355
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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 | 8761885-3501
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License Number State | UT
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