Individual
MICHELLE CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSW
Contact information
Practice address
80 S ORANGE ST, SALT LAKE CITY, UT 84116-3066
(385) 358-2725
Mailing address
80 S ORANGE ST, SALT LAKE CITY, UT 84116-3066
(385) 358-2725
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13528289-3503
UT
Other
Enumeration date
09/21/2023
Last updated
10/12/2023
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