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Individual

MERRILEE BUCHANAN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1753 SIDEWINDER DR, PARK CITY, UT 84060-7258
(435) 649-8347
(435) 649-2157
Mailing address
1735 PHEASANT WAY, PARK CITY, UT 84098-5431
(435) 649-8133
(435) 649-2157

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3146783501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107004105101
INTERMOUNTAIN HEALTH CARE
UT
01
690947
DESERET MUTUAL
UT
01
942938348001
CHAMPUS
UT
Enumeration date
01/31/2006
Last updated
07/08/2007
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