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Organization

GAYLE PHILLIPS, LCSW INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GAYLE PHILLIPS LCSW (CEO)
(801) 352-5714
Entity
Organization

Contact information

Practice address
860 E 4500 S, SUITE #302, SALT LAKE CITY, UT 84107-3002
(801) 352-5714
Mailing address
PO BOX 17076, SALT LAKE CITY, UT 84117-0076
(801) 352-5714
(801) 288-0621

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
136310-3501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1720007222
INDIVIDUAL NPI
UT
Enumeration date
08/12/2006
Last updated
12/27/2010
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