Individual
CELISA PACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2020 E LAKE ST, SALT LAKE CITY, UT 84105
(801) 487-7778
Mailing address
1760 W 4805 S, TAYLORSVILLE, UT 84129-1177
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9046926-3502
UT
1041S0200X
School Social Worker
689820
UT
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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