MEDICARE: MCKENZIE VIERIG LMFT

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	106H00000X	Marriage & Family Therapist		UT
2	106H00000X	Marriage & Family Therapist	7445017-3902	UT

General Provider Information

NPI Number	:	1356689566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MCKENZIE VIERIG LMFT

Provider Business Mailing Address
First Line	:	1538 E WINWARD DR
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84117-7536
Country	:	US
Telephone Number	:	702-561-1603
Fax Number	:

Provider Business Practice Location Address
First Line	:	4568 S HIGHLAND DR STE 380
Second Line	:
City	:	MILLCREEK
State	:	UT
Zip	:	84117
Country	:	US
Telephone Number	:	385-448-0835
Fax Number	:

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

Provider Enumeration Date	:	01/22/2013
Last Update Date	:	11/14/2019

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Directions to “ MCKENZIE VIERIG LMFT” Practice Location

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