Organization
UTAH CLINICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY GOMEZ LCSW (OWNER/OPERATOR)
(435) 503-6474
Entity
Organization
Contact information
Practice address
3500 HARRISON BLVD STE 102, OGDEN, UT 84403-2027
(435) 503-6474
Mailing address
PO BOX 150053, OGDEN, UT 84415-0053
(435) 503-6474
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
81702783501
UT
Other
Enumeration date
09/08/2014
Last updated
09/08/2014
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