Individual
GINA MARIE MAKOUSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
660 S 200 E, SALT LAKE CITY, UT 84111-3835
(801) 359-2256
Mailing address
660 S 200 E, SALT LAKE CITY, UT 84111-3835
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12236527-3502
UT
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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