Individual
KARA BROADHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
117 W 400 S, SALT LAKE CITY, UT 84101-1916
(801) 428-4257
Mailing address
117 W 400 S, SALT LAKE CITY, UT 84101-1916
(801) 428-4257
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396085718
—
UT
Enumeration date
08/06/2020
Last updated
05/30/2024
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