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Individual

ASHLEY CAROLINA BROG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
75 W 100 S STE 200, LOGAN, UT 84321-5842
(801) 822-2109
Mailing address
1934 N 1200 E, NORTH LOGAN, UT 84341-2006
(801) 822-2109

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
8572468-3501
UT
1041C0700X
Clinical Social Worker
Primary
8572468-3502
UT

Other

Enumeration date
06/13/2013
Last updated
05/13/2024
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