Individual
KATRINA RACHEL VANTASSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1950 CIRCLE OF HOPE DR, SALT LAKE CITY, UT 84112-5500
(801) 646-9697
Mailing address
463 E BRIDLEWOOD DR, MILLCREEK, UT 84107-2812
(801) 668-2514
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6802090222
MI
1041C0700X
Clinical Social Worker
Primary
118813383504
UT
1041S0200X
School Social Worker
11881338-3502
UT
Other
Enumeration date
11/01/2018
Last updated
09/06/2024
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