Individual
MARIEL MICHELLE BALZOTTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW, MSW
Contact information
Practice address
1190 N 900 E, PROVO, UT 84604-3536
(801) 631-4109
Mailing address
1190 N 900 E, PROVO, UT 84604-3536
(801) 631-4109
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007649
IA
Other
Enumeration date
09/27/2010
Last updated
05/05/2015
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