Individual
PEGGY DE AZEVEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4885 S 900 E, SALT LAKE CITY, UT 84117-5746
(801) 240-6500
Mailing address
1327 EAST SOUTH TEMPLE, #14, SALT LAKE CITY, UT 84102
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
140103-3501
UT
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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