Doctor Name: | MELANIE E THYGERSON |
NPI Number: | 1073695219 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 8817 Redwood Rd Ste A West Jordan, UT - 840889266 |
Business Phone Number: | 8017482270 |
Business Fax Number: | 8017482271 |
Mailing Address: | 8817 Redwood Rd Ste A, WEST JORDAN |
State: | UT |
Postal Code: | 840889266 |
Phone Number: | 8017482270 |
Fax Number: | 8017482271 |
NPI Enumeration Date: | 10/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |