Individual
MISTY MICHELLE MCINTYRE GOODSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8537 S REDWOOD RD, SUITE A, WEST JORDAN, UT 84088-5713
(801) 694-1830
Mailing address
8537 S REDWOOD RD, SUITE A, WEST JORDAN, UT 84088-5713
(801) 694-1830
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6399706-3501
UT
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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