Individual
MR. CRAIG W BERTHOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
415 MEDICAL DR, SUITE C100, BOUNTIFUL, UT 84010-4946
(801) 292-2389
(801) 292-2873
Mailing address
415 MEDICAL DR, SUITE C100, BOUNTIFUL, UT 84010-4946
(801) 292-2389
(801) 292-2873
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
120978-3501
UT
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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