# KOLOB THERAPEUTIC SERVICES

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

## Provider details

- **NPI number:** 1275800823
- **Authorized official:** MARTHA HAM L.C.S.W. (DIRECTOR)
- **Authorized official phone:** (435) 674-4464

## Contact information

- **Practice address:** 437 S BLUFF ST STE 202, ST GEORGE, UT 84770-3555
- **Practice address phone:** (435) 674-4464
- **Mailing address:** 437 S BLUFF ST STE 202, ST GEORGE, UT 84770-3555
- **Mailing address phone:** (435) 674-4464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 1397173501 | UT | Yes |

## Other

- **Enumeration date:** 11/28/2011
- **Last updated:** 11/28/2011