MEDICARE: MR. HOWARD FRANKLIN DAHLE MS, CMHC

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
1	101YM0800X	Mental Health Counselor	5095471-6004	UT

General Provider Information

NPI Number	:	1245672880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HOWARD FRANKLIN DAHLE MS, CMHC

Provider Business Mailing Address
First Line	:	12093 S POND RIDGE DR
Second Line	:
City	:	DRAPER
State	:	UT
Zip	:	84020-8716
Country	:	US
Telephone Number	:	801-718-6441
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 E 500 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-2818
Country	:	US
Telephone Number	:	801-938-9268
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2013
Last Update Date	:	07/24/2013

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