Individual
FABIOLA MARQUEZ JAMIESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4500 S 2180 E, SUITE 165, HOLLADAY, UT 84117
(801) 461-9060
Mailing address
823 2ND AVE, APT B, SALT LAKE CITY, UT 84103
(801) 360-5191
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
73763963501
UT
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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