Individual
MRS. MEAGAN LAVELLE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
36 S 400 W STE 102, OREM, UT 84058-5359
(801) 251-6884
Mailing address
36 S 400 W STE 102, OREM, UT 84058-5359
(801) 251-6884
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11256803-3502
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11256803-3502
DOPL LICENSING NUMBER
UT
Enumeration date
05/19/2019
Last updated
06/11/2019
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