Individual
CANDICE PACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
130 W MAIN ST, LEHI, UT 84043-2100
(801) 528-3247
(801) 753-0409
Mailing address
130 W MAIN ST, LEHI, UT 84043-2100
(801) 528-3247
(801) 753-0409
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7744469-3502
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770721300
—
UT
Enumeration date
02/21/2011
Last updated
02/21/2011
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