Individual
BLAKE BEECHER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD.
Contact information
Practice address
1020 S MAIN ST, SUITE 300, SALT LAKE CITY, UT 84101-3176
(801) 536-6500
Mailing address
242 CONSTITUTION WAY, NSL, UT 84054-1608
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
349081-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107003582101
INTERMOUNTAIN HEALTH CARE
UT
01
—
682027
DESERET MUTUAL
UT
Enumeration date
01/11/2006
Last updated
07/08/2007
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