Individual
AUDREY HELEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
117 W 400 S, SALT LAKE CITY, UT 84101-1916
(801) 428-4257
Mailing address
117 W 400 S, SALT LAKE CITY, UT 84101-1916
(801) 428-4257
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13469297-3502
UT
Other
Enumeration date
06/04/2024
Last updated
11/15/2024
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