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2180 E 4500 S Ste 210 Holladay UT 84117-4029 | |
| (385) 232-6482 | |
| (385) 232-6482 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2180 E 4500 S Ste 210, Holladay, Utah |
| Authorized Official Name and Position | Christopher Dewey Cavin (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3852326482 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
406 E 300 S 127 Salt Lake City UT 84111 Ph: (385) 232-6482 | 2180 E 4500 S Ste 210 Holladay UT 84117-4029 Ph: (385) 232-6482 |
| NPI Number | 1558869255 |
|---|---|
| Provider Enumeration Date | 01/28/2018 |
| Last Update Date | 01/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558869255 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 7095872-3501 (Utah) | Primary |
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