Michael Lee Van Dam, LCSW

NPI #1386729994 in Centerville, Utah

Provider Information

NPI Number: 1386729994
Entity Type: Individual
Name: Michael Lee Van Dam, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Oct 25, 2006
Last Updated: Jun 23, 2009

Practice Location

Address: 94 E PAGES LN
Address 2: SUITE A
City: Centerville
State: Utah
ZIP Code: 84014-2216
Phone: (801) 294-0578

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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