Individual
LORI ELLEN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1200 EAST 3900 SOUTH, SALT LAKE CITY, UT 84124
(801) 243-6924
Mailing address
4956 W 6200 S # 315, KEARNS, UT 84118-6703
(801) 243-6924
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
276246-3501
UT
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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