Individual
MR. MARK ALAN WEISBENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3195 S MAIN ST STE 180, SOUTH SALT LAKE, UT 84115-3790
(801) 983-5540
(801) 983-5542
Mailing address
PO BOX 824, DRAPER, UT 84020-0801
(801) 983-5540
(801) 983-5542
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
263270-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
788007788802
—
UT
Enumeration date
04/05/2006
Last updated
08/04/2023
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