Deberard, Michael Scott

Deberard, Michael Scott is an individual health care provider with primary practice located at 2810 Old Main Hl , Logan UT 84322-2810. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Deberard, Michael Scott can be contacted via phone (435) 797-3401.

Contact Information

Primary practice address
2810 Old Main Hl Logan UT 84322-2810
Phone: (435) 797-3401
Fax: (435) 797-1448
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 50289442501 Utah

Profile Details

NPI number 1568581056
LBN Legal business name Deberard, Michael Scott
Credentials PHD, M.S., B.A.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568581056 NPPES
Utah Other 50289442500001 BCBS PROVIDER NUMBER

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