Individual
KRISTINA RAE MCDOUGAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1140 36TH ST, OGDEN, UT 84403-2050
(801) 631-2380
Mailing address
3055 W 4450 S, ROY, UT 84067-9559
(801) 631-2380
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7711976-3502
UT
Other
Enumeration date
09/08/2010
Last updated
07/10/2020
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