Individual
AMANDA CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1747 HERITAGE LN STE B101, SYRACUSE, UT 84075-8546
(385) 439-1926
Mailing address
2623 N 1575 E, LAYTON, UT 84040-8509
(801) 671-5622
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
12/19/2019
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