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Individual

MOLLY THEURER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3980 S 700 E STE 22, SALT LAKE CITY, UT 84107-2589
(385) 743-2728
Mailing address
4255 NW COLUMBIA AVE, PORTLAND, OR 97229-2951
(801) 706-5559

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7360701-3501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
04/08/2008
Last updated
03/12/2021
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