Individual
MR. MARLIN V ANDRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1196 W SOUTH JORDAN PKWY STE A3, SOUTH JORDAN, UT 84095-4604
(801) 253-3169
(801) 446-4499
Mailing address
1196 W SOUTH JORDAN PKWY STE A3, SOUTH JORDAN, UT 84095-4604
(801) 253-3169
(801) 446-4499
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
133426-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1334263501
STATE PROFESSIONAL LICENS
UT
Enumeration date
01/08/2007
Last updated
07/08/2007
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