Individual
SARA GODY JACKSON BYBEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 662-3606
(801) 662-3610
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(385) 549-7057
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8300623-3501
DOPL
UT
Enumeration date
05/13/2015
Last updated
10/20/2015
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