Individual
KRISTA LEE NIEDERJOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW, MSW, MED
Contact information
Practice address
124 S 400 E STE 230, SALT LAKE CITY, UT 84111-5313
(801) 651-0685
Mailing address
1061 E SOUTH TEMPLE, SALT LAKE CITY, UT 84102-1521
(801) 651-0685
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13783945-3502
UT
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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