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NPI Code Detail

MEDICARE: DANIEL RICHARD MIGGIN M.S., L.M.F.T.

MEDICARE: DANIEL RICHARD MIGGIN M.S., L.M.F.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist5013096-3902UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111605584OTHERUTAETNA
2107021829101OTHERUTIHC
370587OTHERUTPEHP

General Provider Information

NPI Number : 1033219845
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL RICHARD MIGGIN M.S., L.M.F.T.
Provider Business Mailing Address
First Line : 213 W 300 N
Second Line :
City : HYDE PARK
State : UT
Zip : 84318-4020
Country : US
Telephone Number : 435-563-6946
Fax Number : 435-752-7433
Provider Business Practice Location Address
First Line : 90 E 200 N
Second Line :
City : LOGAN
State : UT
Zip : 84321-4034
Country : US
Telephone Number : 435-752-0750
Fax Number : 435-752-7433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 07/08/2007

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