Individual
MARC LEE ANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1747 HERITAGE LN STE B101, SYRACUSE, UT 84075-8546
(385) 439-1926
Mailing address
1141 W 3090 S, SYRACUSE, UT 84075-9083
(801) 791-2073
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5780998-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876000308007
—
UT
Enumeration date
08/01/2008
Last updated
12/19/2019
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