Individual
MADISON GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1576 W 500 S #202, BOUNTIFUL, UT 84010
(317) 643-0626
Mailing address
1324 E 4200 S, MILLCREEK, UT 84124-2525
(503) 680-3744
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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