| Doctor Name: | MR. TRAVIS CLYDE CHRISTENSEN |
| NPI Number: | 1154642957 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 6322605-6004 |
| Business Practice Address: | 3149 N Hwy 89 Pleasant View, UT - 844041201 |
| Business Phone Number: | 8017826600 |
| Business Fax Number: | 8017826551 |
| Mailing Address: | 3149 N Hwy 89, PLEASANT VIEW |
| State: | UT |
| Postal Code: | 844041201 |
| Phone Number: | 8017826600 |
| Fax Number: | 8017826551 |
| NPI Enumeration Date: | 06/15/2010 |
| NPI Last Update Date: | 06/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6322605-6004 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |