Provider Demographics
NPI:1013160860
Name:STEPHENS-BURTON, MARILYN D (LMFT, MA)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:D
Last Name:STEPHENS-BURTON
Suffix:
Gender:F
Credentials:LMFT, MA
Other - Prefix:MS
Other - First Name:MARILYN
Other - Middle Name:
Other - Last Name:STEPHENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:930 W HILL FIELD ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041
Mailing Address - Country:US
Mailing Address - Phone:801-336-3040
Mailing Address - Fax:801-336-3041
Practice Address - Street 1:930 W HILL FIELD ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041
Practice Address - Country:US
Practice Address - Phone:801-336-3040
Practice Address - Fax:801-336-3041
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4952005-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist