Individual
ANDRA DEVAIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
749 LOGAN AVE, SALT LAKE CITY, UT 84105-2228
(801) 695-1316
Mailing address
PO BOX 12842, OGDEN, UT 84412-2842
(801) 695-1316
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5970951-3501
UT
Other
Enumeration date
02/01/2008
Last updated
02/01/2008
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