Individual
BRANDI KOLDITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
4460 S HIGHLAND DR, SALT LAKE CITY, UT 84124-3543
(801) 263-7100
Mailing address
1537 N 3890 W, LEHI, UT 84043-6900
(435) 327-1776
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12358022-3506
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12358022-3502
DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSING
UT
05
—
1376927830
—
UT
Enumeration date
07/15/2015
Last updated
03/17/2023
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