Individual
MICHELLE YBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7321 BALMER ST, HILL AIR FORCE BASE, UT 84056
(801) 777-0728
Mailing address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9495031-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194194555
TRICARE
UT
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
09/16/2015
Last updated
12/17/2018
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