| Gayle Phillips, Lcsw Inc | |
|
860 E 4500 S Suite #302 Salt Lake City UT 84107-3002 | |
| (801) 352-5714 | |
| Not Available |
| Full Name | Gayle Phillips, Lcsw Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 860 E 4500 S, Salt Lake City, Utah |
| Authorized Official Name and Position | Gayle Phillips (CEO) |
| Authorized Official Contact | 8013525714 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gayle Phillips, Lcsw Inc Po Box 17076 Salt Lake City UT 84117-0076 Ph: (801) 352-5714 | Gayle Phillips, Lcsw Inc 860 E 4500 S Suite #302 Salt Lake City UT 84107-3002 Ph: (801) 352-5714 |
| NPI Number | 1336151117 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 12/27/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336151117 | NPI | - | NPPES |
| 1720007222 | Other | UT | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 136310-3501 (Utah) | Primary |
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