Individual
MR. BRENT CARMAN PACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
1164 E 1ST AVE, SALT LAKE CITY, UT 84103-4108
(801) 599-6279
Mailing address
1164 E 1ST AVE, SALT LAKE CITY, UT 84103-4108
(801) 599-6279
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3287263501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32872635000001
BLUE CROSS
UT
Enumeration date
01/28/2006
Last updated
12/08/2022
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