Individual
TINA REBECCA CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSW
Contact information
Practice address
PO BOX 6, MORONI, UT 84646-0006
(385) 895-7813
Mailing address
PO BOX 6, MORONI, UT 84646-0006
(385) 895-7813
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
110575953503
UT
Other
Enumeration date
06/14/2025
Last updated
06/14/2025
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