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Organization

J MANUEL DE LA TORRE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JESUS MANUEL DE LA TORRE LCSW (PRESIDENT OWNER)
(801) 973-0655
Entity
Organization

Contact information

Practice address
1579 W 6005, SLC, UT 84104-2512
(801) 973-0655
(801) 973-0655
Mailing address
1579 W 6005, SLC, UT 84104-2512
(801) 973-0655
(801) 973-0655

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1315073501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
518647999000
UT
05
518647999013
UT
Enumeration date
12/22/2006
Last updated
08/22/2020
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