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Individual

ANNA CONNOLLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CSW

Contact information

Practice address
2655 S LAKE ERIE DR, WEST VALLEY CITY, UT 84120-7350
(801) 856-4863
Mailing address
2057 E ATKIN AVE, SALT LAKE CITY, UT 84109-1901
(801) 856-4863

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11351677-3502
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
NA
Enumeration date
08/22/2019
Last updated
08/22/2019
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