Individual
MISS JODI ANN SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
VALLEY MENTAL HEALTH CTP, 3944 SOUTH 400 EAST, SALT LAKE CITY, UT 84107
(801) 261-1442
Mailing address
612 HARRISON AVE, SALT LAKE CITY, UT 84105-2119
(801) 487-5824
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3734263501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107021470101
INTERMNT HEALTH CARE
UT
01
—
682028
DESERET MUTUAL
UT
01
—
942938348011
CHAMPUS
UT
Enumeration date
01/31/2006
Last updated
07/08/2007
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