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Individual

CRAIG T. SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
503 W 2600 S # N, BOUNTIFUL, UT 84010-7717
(801) 357-9475
Mailing address
PO BOX 414, KAYSVILLE, UT 84037-0414
(801) 357-9475

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
77314983502
UT
1041C0700X
Clinical Social Worker
Primary
77314983501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
260022408
RAILROAD MEDICARE
UT
05
876000308007
UT
Enumeration date
03/07/2011
Last updated
06/10/2019
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