Individual
MS. PHYLLIS SPECIALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1141 E 3900 S, A-170, SALT LAKE CITY, UT 84124-1215
(801) 270-6538
(801) 284-4991
Mailing address
2640 CHADWICK ST, SALT LAKE CITY, UT 84106-3506
(801) 467-6617
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1235423501
UT
Other
Enumeration date
12/13/2005
Last updated
04/09/2012
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