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Individual
TIMOTHY E ADAMS
Active
Individual
TIMOTHY E ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
287810-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02878103500001
BLUE CROSS
—
01
—
5995175
AETNA
—
05
—
870298699000
—
UT
Enumeration date
08/17/2007
Last updated
08/17/2007
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