Individual
SAMANTHA DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
5689 S REDWOOD RD UNIT 27, SALT LAKE CITY, UT 84123-5499
(801) 735-7491
Mailing address
5689 S REDWOOD RD UNIT 27, SALT LAKE CITY, UT 84123-5499
(801) 735-7491
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8490034-3502
UT
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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