Provider Demographics
NPI:1033554159
Name:OKULA, PAWEL (MFTGS)
Entity Type:Individual
Prefix:
First Name:PAWEL
Middle Name:
Last Name:OKULA
Suffix:
Gender:M
Credentials:MFTGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 S COMMERCE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5389
Mailing Address - Country:US
Mailing Address - Phone:801-261-3500
Mailing Address - Fax:
Practice Address - Street 1:5250 S COMMERCE DR STE 250
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5389
Practice Address - Country:US
Practice Address - Phone:801-261-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist