Provider Demographics
NPI:1891917555
Name:SLOVER, MARY (LMFT)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:SLOVER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 OAK LN
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-2126
Mailing Address - Country:US
Mailing Address - Phone:801-377-4164
Mailing Address - Fax:
Practice Address - Street 1:1190 N 900 E
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3536
Practice Address - Country:US
Practice Address - Phone:801-422-7620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT347519-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist