Stages Family Therapy Pllc | |
4095 E Pony Express Pkwy Ste 15 Eagle Mountain UT 84005-5529 | |
(801) 200-2506 | |
Not Available |
Full Name | Stages Family Therapy Pllc |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 4095 E Pony Express Pkwy Ste 15, Eagle Mountain, Utah |
Authorized Official Name and Position | Derek Willis Hagey (CO-OWNER) |
Authorized Official Contact | 8012002506 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Stages Family Therapy Pllc 2039 E Ficus Way Eagle Mtn UT 84005-5741 Ph: (801) 200-2506 | Stages Family Therapy Pllc 4095 E Pony Express Pkwy Ste 15 Eagle Mountain UT 84005-5529 Ph: (801) 200-2506 |
NPI Number | 1437740487 |
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Provider Enumeration Date | 02/02/2021 |
Last Update Date | 02/02/2021 |
Certification Date | 02/02/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437740487 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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