Individual
JUSTIN ALLEN NORTHWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2948 S REDWOOD RD, WEST VALLEY, UT 84119-2323
(888) 949-4864
Mailing address
PO BOX 572070, MURRAY, UT 84157-2070
(801) 263-7100
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6377910-3501
UT
Other
Enumeration date
10/30/2018
Last updated
12/12/2018
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