Individual
MRS. CHRISTINA KELLY LECLUYSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1578 W 1700 S, SALT LAKE CITY, UT 84104-3470
(801) 972-2711
Mailing address
1578 W 1700 S, SALT LAKE CITY, UT 84104-3470
(801) 972-2711
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6213977-3501
UT
Other
Enumeration date
04/02/2014
Last updated
08/22/2014
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