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Individual

MRS. JANICE MADDISON MARTENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
51 E 800 N, SPANISH FORK, UT 84660-1210
(435) 314-9623
Mailing address
1571 S 400 E, OREM, UT 84058-8304
(801) 885-0903

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
10493826-3501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
84-2224657
UT
Enumeration date
01/13/2014
Last updated
02/01/2024
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