Individual
CANDICE JANE CHILD-ILLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW, MSW
Contact information
Practice address
3149 N HIGHWAY 89 STE 200, PLEASANT VIEW, UT 84404-1202
(801) 782-6600
Mailing address
3149 N HIGHWAY 89 STE 200, PLEASANT VIEW, UT 84404-1202
(801) 782-6600
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11187387-3502
UT
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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