Individual
CARISSA REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
11618 S STATE ST STE 1604, DRAPER, UT 84020-7123
(385) 202-5645
Mailing address
11618 S STATE ST STE 1604, DRAPER, UT 84020-7123
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11782053-3502
UT
1041C0700X
Clinical Social Worker
11782053-3502
UT
Other
Enumeration date
06/23/2020
Last updated
09/29/2020
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