Individual
KATIE FISHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 S GENEVA RD, OREM, UT 84059-5803
(801) 877-5300
Mailing address
4978 W FROGS LEAP DR APT 2204, SOUTH JORDAN, UT 84009-4751
(805) 990-5128
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11022383
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11022383-3502
DOPL; CERTIFIED SOCIAL WORKER
UT
Enumeration date
08/04/2020
Last updated
11/27/2023
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