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Individual

ROBERT S GORELIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
8834 GORGOZA DR, PARK CITY, UT 84098-4734
(435) 645-9336
Mailing address
8834 GORGOZA DR, PARK CITY, UT 84098-4734

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1373693501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107000923101
INTERMOUNTIAN HEALTH CARE
UT
01
292735
DESERET MUTUAL INSURANCE
UT
01
942938348GO1
EDUCATORS MUTUAL
UT
Enumeration date
10/26/2006
Last updated
04/23/2008
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