Organization
MARYBETH RAYNES L.C.S.W., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL WHITE (BUSINESS MANAGER)
(801) 531-7389
Entity
Organization
Contact information
Practice address
275 E SOUTH TEMPLE STE 101, SALT LAKE CITY, UT 84111-1243
(801) 531-7389
(801) 364-1433
Mailing address
275 E SOUTH TEMPLE STE 101, SALT LAKE CITY, UT 84111-1243
(801) 531-7389
(801) 364-1433
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
22124871-3501
UT
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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