Individual
DAKOTA POND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
6405 OLD MAIN HILL, LOGAN, UT 84322-8004
(435) 797-0388
Mailing address
6405 OLD MAIN HILL, LOGAN, UT 84322-6405
(435) 797-4200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
11305671-3502
UT
1041C0700X
Clinical Social Worker
Primary
11305671-3501
UT
Other
Enumeration date
07/03/2017
Last updated
10/24/2022
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