Individual
MRS. REBECCA CONNIE PEDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW,SUDP,LCSW
Contact information
Practice address
802 E BAMBERGER DR STE A, AMERICAN FORK, UT 84003-2179
(801) 633-9887
Mailing address
802 E BAMBERGER DR STE A, AMERICAN FORK, UT 84003-2179
(801) 633-9887
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60818488
WA
1041C0700X
Clinical Social Worker
Primary
365936-3501
UT
1041C0700X
Clinical Social Worker
LW61089331
WA
Other
Enumeration date
05/14/2015
Last updated
10/02/2024
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