Individual
ELISHA NICHOLE BETANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
7625 S 3200 W STE 2, WEST JORDAN, UT 84084-2887
(801) 915-0359
Mailing address
603 S 1300 W, SALT LAKE CITY, UT 84104-2628
(909) 559-0533
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10518360-3502
UT
Other
Enumeration date
12/19/2017
Last updated
12/19/2017
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