Individual
RANDAL THERON DOW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3809 W 6200 S, KEARNS, UT 84118-3725
(801) 963-4215
(801) 963-4299
Mailing address
3809 W 6200 S, KEARNS, UT 84118-3725
(801) 963-4215
(801) 963-4299
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
881346053501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107001374101
INTERMOUNTAIN HEALTH CARE
UT
01
—
13460535000001
BLUE CROSS
UT
01
—
261880
DESERET MUTUAL
UT
Enumeration date
01/09/2006
Last updated
07/08/2007
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