Individual
MS. ANNALISE JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3556 S 5600 W # 1-660, WEST VALLEY CITY, UT 84120-2815
(651) 269-5019
Mailing address
3556 S 5600 W # 1-660, WEST VALLEY CITY, UT 84120-2815
(651) 269-5019
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12377650-3501
UT
1041C0700X
Clinical Social Worker
25733
MN
Other
Enumeration date
06/19/2013
Last updated
08/21/2021
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