| Modern Family Therapy Services Limited Liability Company | |
|
4933 S 1500 W Ste 200 Riverdale UT 84405-7738 | |
| (801) 896-3284 | |
| Not Available |
| Full Name | Modern Family Therapy Services Limited Liability Company |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4933 S 1500 W Ste 200, Riverdale, Utah |
| Authorized Official Name and Position | Marla Willard (OWNER) |
| Authorized Official Contact | 8018963284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Family Therapy Services Limited Liability Company 5040 S 3300 W Roy UT 84067-8666 Ph: (801) 896-3284 | Modern Family Therapy Services Limited Liability Company 4933 S 1500 W Ste 200 Riverdale UT 84405-7738 Ph: (801) 896-3284 |
| NPI Number | 1639822042 |
|---|---|
| Provider Enumeration Date | 01/27/2022 |
| Last Update Date | 01/27/2022 |
| Certification Date | 01/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639822042 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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