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Individual

ALISHA DELACRUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
7319 BALMER ST # 546, HILL AFB, UT 84056-5012
(801) 777-3497
Mailing address
7319 BALMER ST # 546, HILL AFB, UT 84056-5012
(801) 777-3497

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW007607
GA
1041C0700X
Clinical Social Worker
10882419-3501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MSW007607
LICENSE
GA
Enumeration date
02/09/2017
Last updated
06/29/2020
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