Individual
MR. JOSEPH HENRY TABISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
3378 SOUTH 900 EAST, SALT LAKE CITY, UT 84106-2070
(801) 463-7520
(801) 463-7525
Mailing address
3378 SOUTH 900 EAST, SALT LAKE CITY, UT 84106-2070
(801) 463-7520
(801) 463-7525
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
139727-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005569802
MEDICARE A
UT
01
—
5286974304001
BLUE CROSS BLUE SHIELD
UT
Enumeration date
02/14/2008
Last updated
09/24/2012
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