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Individual

CLARE JULIAN STEPHANIE CARBONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4465 S 900 E STE 150, SALT LAKE CITY, UT 84124-3944
(435) 248-2089
(801) 207-5104
Mailing address
4465 S 900 E STE 150, SALT LAKE CITY, UT 84124-3944
(435) 248-2089
(801) 207-5104

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1392273501
UT
1041C0700X
Clinical Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1265841795
BLUE CROSS BLUE SHIELD
Enumeration date
08/08/2014
Last updated
08/19/2019
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