Individual
MR. MARK DAVID DE ST. AUBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, CT
Contact information
Practice address
5005 S 900 E STE 120, SALT LAKE CITY, UT 84117-5711
(801) 891-3137
Mailing address
3351 EL SERRITO DR, SALT LAKE CITY, UT 84109-4249
(801) 891-3137
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
133556-3501
UT
Other
Enumeration date
02/03/2011
Last updated
02/03/2011
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