Individual
MR. ALAN RUSHBY CHIDESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3135 N FAIRFIELD RD STE A, LAYTON, UT 84041-8832
(801) 771-9099
Mailing address
1435 VINEYARD CIR, BOUNTIFUL, UT 84010-8800
(801) 455-4089
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5935746-3501
UT
Other
Enumeration date
06/02/2011
Last updated
06/02/2011
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