# J MANUEL DE LA TORRE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164586061
- **Authorized official:** MR. JESUS MANUEL DE LA TORRE LCSW (PRESIDENT OWNER)
- **Authorized official phone:** (801) 973-0655

## Contact information

- **Practice address:** 1579 W 6005, SLC, UT 84104-2512
- **Practice address phone:** (801) 973-0655
- **Practice address fax:** (801) 973-0655
- **Mailing address:** 1579 W 6005, SLC, UT 84104-2512
- **Mailing address phone:** (801) 973-0655
- **Mailing address fax:** (801) 973-0655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 1315073501 | UT | Yes |

## Other

- **Enumeration date:** 12/22/2006
- **Last updated:** 08/22/2020