| Blake Thomas Halliday, LMFT | |
|
5149 S 1500 W, Riverdale, UT 84405-3926 | |
| (801) 475-0402 | |
| (801) 475-7464 |
| Full Name | Blake Thomas Halliday |
|---|---|
| Gender | Male |
| Speciality | Marriage & Family Therapist |
| Location | 5149 S 1500 W, Riverdale, Utah |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710068473 | NPI | - | NPPES |
| 260022408 | Other | RAILROAD MEDICARE | |
| 876000308007 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 5989003-3902 (Utah) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Blake Thomas Halliday, LMFT 5149 S 1500 W, Riverdale, UT 84405-3926 Ph: (801) 475-0402 | Blake Thomas Halliday, LMFT 5149 S 1500 W, Riverdale, UT 84405-3926 Ph: (801) 475-0402 |
Taylor Cameron Herrin, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 5149 S 1500 W, Riverdale, UT 84405 Phone: 801-475-0402 Fax: 801-475-7464 | |
Angie Berry, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 5149 S 1500 W, Riverdale, UT 84405 Phone: 801-475-0402 Fax: 801-475-7464 |