Individual
MR. REYNIE THOMAS SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
853 N 1200 E, PROVO, UT 84604-3526
(801) 473-8844
Mailing address
853 N 1200 E, PROVO, UT 84604-3526
(801) 473-8844
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4976881-3501
UT
Other
Enumeration date
08/23/2010
Last updated
12/18/2015
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