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Individual

GREGORY GLADE SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9361 S 300 E, SANDY, UT 84070-2902
(801) 826-5000
Mailing address
9361 S 300 E, SANDY, UT 84070-2902

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
UT
390200000X
Student in an Organized Health Care Education/Training Program
390200000
UT

Other

Enumeration date
08/15/2013
Last updated
06/15/2022
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