Organization
B. SHANE HARMON LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. B. SHANE HARMON LCSW (MANAGER)
(801) 475-0402
Entity
Organization
Contact information
Practice address
5149 S 1500 W, RIVERDALE, UT 84405-3926
(801) 475-0402
(801) 475-7464
Mailing address
5149 S 1500 W, RIVERDALE, UT 84405-3926
(801) 475-0402
(801) 475-7464
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
141805-3501
UT
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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