Individual
ELIZABETH CHARLOTTE TEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5965 S 900 E, SALT LAKE CITY, UT 84121-1720
(801) 263-7100
Mailing address
PO BOX 572070, SALT LAKE CITY, UT 84121-1720
(801) 263-7100
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8272286-3501
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/15/2011
Last updated
05/18/2017
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