Individual
ANNTOINETTE TAMARA TITUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
237 26TH ST, OGDEN, UT 84401-3105
(801) 778-6824
Mailing address
2536 N 1600 E, OGDEN, UT 84414-2593
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5527707-3502
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876000308007
—
UT
Enumeration date
04/09/2007
Last updated
07/08/2007
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