Individual
CHARLENE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1515 S 1100 E, SALT LAKE CITY, UT 84105-2424
(801) 712-6213
Mailing address
375 E WILSON AVE, SALT LAKE CITY, UT 84115-1744
(801) 712-6213
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7573964-3501
UT
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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