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Individual

DUSTIN E GEORGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
9140 S STATE ST STE 201, SANDY, UT 84070-2694
(385) 645-4593
Mailing address
9140 S STATE ST STE 201, SANDY, UT 84070-2694

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1041C0700X
Clinical Social Worker
116635-01
NY
1041C0700X
Clinical Social Worker
Primary
13897520-3501
UT

Other

Enumeration date
06/29/2022
Last updated
11/22/2024
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