Individual
ERIC YOSHIO JESUS TADEHARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
934 S MAIN ST, LAYTON, UT 84041-7135
(801) 773-7060
Mailing address
934 S MAIN ST, LAYTON, UT 84041-7135
(801) 773-7060
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
7069553-3503
UT
1041C0700X
Clinical Social Worker
Primary
7069553-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870430116009
—
UT
Enumeration date
08/07/2008
Last updated
04/06/2016
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