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Individual

MR. THOMAS EDWARD ROBERTSHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SSW

Contact information

Practice address
750 N 200 W, PROVO, UT 84601-1677
(801) 373-4760
Mailing address
750 N FREEDOM BLVD STE 300, PROVO, UT 84601-1690
(801) 373-4760

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
137653-3503
UT
104100000X
Social Worker
171M00000X
Case Manager/Care Coordinator
SSW137653-3503
UT

Other

Enumeration date
04/15/2009
Last updated
04/28/2023
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