Individual
B DIANE GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5030 HARRISON BLVD, OGDEN, UT 84403-4311
(801) 387-5600
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 387-5600
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
138499-3501
UT
Other
Enumeration date
04/17/2007
Last updated
12/03/2012
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