Provider Demographics
NPI:1033219845
Name:MIGGIN, DANIEL RICHARD (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RICHARD
Last Name:MIGGIN
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:DAN
Other - Middle Name:
Other - Last Name:MIGGIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:213 W 300 N
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84318-4020
Mailing Address - Country:US
Mailing Address - Phone:435-563-6946
Mailing Address - Fax:435-752-7433
Practice Address - Street 1:90 E 200 N
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-4034
Practice Address - Country:US
Practice Address - Phone:435-752-0750
Practice Address - Fax:435-752-7433
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5013096-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT11605584OtherAETNA
UT107021829101OtherIHC
UT70587OtherPEHP