Individual
MR. CORY MELVIN SHIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1141 EAST 3900 SOUTH, SUITE A-170, SALT LAKE CITY, UT 84124
(801) 284-4990
(801) 284-4991
Mailing address
1141 E 3900 S, SUITE A-170, SALT LAKE CITY, UT 84124-1215
(801) 284-4990
(801) 284-4991
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4933215-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
493321535000001
BLUE CROSS
UT
Enumeration date
12/06/2005
Last updated
11/03/2009
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