Individual
MRS. GINA MARIE ATTALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
2525 S LAKE PARK BLVD, OPTUMHEALTH, WEST VALLEY CITY, UT 84120-8230
(801) 982-3064
(801) 982-3159
Mailing address
1795 S 1700 E, SALT LAKE CITY, UT 84108-2970
(801) 971-2845
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
49721143501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10704211101
INTRMTN. HEALTH CARE
UT
01
—
49721143500001
BLUE CROSS
UT
Enumeration date
01/25/2006
Last updated
09/11/2012
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