Organization
MARY BETH WHITTAKER LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH WHITTAKER LCSW (OWNER)
(801) 272-3533
Entity
Organization
Contact information
Practice address
2290 E 4500 S, SUITE 210, HOLLADAY, UT 84117-4492
(801) 272-3533
(801) 272-3636
Mailing address
2290 E 4500 S, SUITE 210, HOLLADAY, UT 84117-4492
(801) 272-3533
(801) 272-3636
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
130283-3501
UT
Other
Enumeration date
09/19/2015
Last updated
09/19/2015
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