Individual
AMANDA HARDMAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4578 S HIGHLAND DR STE 190, MILLCREEK, UT 84117-4204
(801) 520-5247
Mailing address
2910 E 3215 S, MILLCREEK, UT 84109-2122
(801) 520-5247
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
0009923203
CO
1041C0700X
Clinical Social Worker
Primary
12881848-3501
UT
Other
Enumeration date
10/08/2020
Last updated
10/15/2024
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