Individual
MS. SUSAN M DEZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1760 W 4805 S, TAYLORSVILLE, UT 84118-1177
(801) 955-9110
Mailing address
6277 KING VALLEY LN, WEST VALLEY CITY, UT 84128-4343
(801) 209-6492
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
127032-3502
UT
Other
Enumeration date
03/17/2006
Last updated
06/23/2010
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