Individual
LATEISHA LYNN GOLUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9176 S 300 W, SANDY, UT 84070-2668
(801) 520-5749
(801) 478-5869
Mailing address
4000 S 700 E STE 9, SALT LAKE CITY, UT 84107-2581
(801) 639-9544
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
89741963501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326474446
—
UT
Enumeration date
09/20/2013
Last updated
02/14/2020
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