Individual
BETHANY H LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
650 KOMAS DR, 200, SALT LAKE CITY, UT 84108-1215
(801) 581-5515
(801) 585-5600
Mailing address
650 KOMAS DR, 200, SALT LAKE CITY, UT 84108-1215
(801) 581-5515
(801) 585-5600
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
77364043502
UT
1041C0700X
Clinical Social Worker
Primary
77364043502
UT
Other
Enumeration date
01/24/2012
Last updated
04/20/2023
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