Organization
A SAFE PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN KELLY GRANT (LCSW)
(801) 563-5906
Entity
Organization
Contact information
Practice address
11075 S STATE ST STE 30, SANDY, UT 84070-5129
(801) 793-8774
Mailing address
7460 GREENWOOD VILLAGE DR, MIDVALE, UT 84047-2260
(801) 793-8774
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/27/2012
Last updated
07/19/2012
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