Individual
DR. DAVID EDMAND RODEBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3838 S 700 E STE 100, SALT LAKE CITY, UT 84106-1494
(801) 269-0231
Mailing address
1121 E 3900 S STE C230, SALT LAKE CITY, UT 84124-1297
(801) 266-0878
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
138978 3501
UT
1041C0700X
Clinical Social Worker
Primary
138978-3501
UT
Other
Enumeration date
04/09/2008
Last updated
03/31/2020
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