Individual
BARRY ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3944 S 400 E, SALT LAKE CITY, UT 84107-1600
(801) 261-1442
(801) 261-9569
Mailing address
3944 S 400 E, SALT LAKE CITY, UT 84107-1600
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
971363963501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107032376101
INTERMOUNTAIN HEALTH CARE
UT
01
—
341613
U002-DESERET MUTUAL
UT
01
—
942938348R02
U003-EDUCATORS MUTUAL
UT
01
—
S74153
ICAR
UT
Enumeration date
01/17/2006
Last updated
07/08/2007
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