Individual
MS. CONNIE R MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2525 LAKE PARK BLVD, WEST VALLEY, UT 84120-8230
(801) 982-3038
Mailing address
2525 LAKE PARK BLVD, WEST VALLEY, UT 84120-8230
(801) 982-3038
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
137478-3501
UT
1041C0700X
Clinical Social Worker
19905
CA
Other
Enumeration date
01/03/2006
Last updated
07/25/2011
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