| Doctor Name: | MR. BRADLEY KENT GARVIN |
| NPI Number: | 1174741433 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.P.C |
| License Number: | 140019-6004 |
| Business Practice Address: | 7487 S 95 E Midvale, UT - 840472150 |
| Business Phone Number: | 8018038517 |
| Business Fax Number: | |
| Mailing Address: | Po Box 183, BOUNTIFUL |
| State: | UT |
| Postal Code: | 840110183 |
| Phone Number: | 8018038517 |
| Fax Number: | |
| NPI Enumeration Date: | 04/23/2007 |
| NPI Last Update Date: | 02/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 140019-6004 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |