Individual
CORINNE IVY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
525 E 100 S FL 5, SALT LAKE CITY, UT 84102-4210
(801) 585-1212
Mailing address
803 E 1ST AVE APT 3, SALT LAKE CITY, UT 84103-3990
(801) 608-5358
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
94725933501
UT
Other
Enumeration date
02/22/2019
Last updated
12/10/2021
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