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Individual

ANNABELLA ZAMARA HAGEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3549 N UNIVERSITY AVE, SUITE 300-A, PROVO, UT 84604-4487
(801) 427-1054
(801) 375-0348
Mailing address
3549 N UNIVERSITY AVE, SUITE 300-A, PROVO, UT 84604-4487
(801) 427-1054
(801) 375-0348

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
47266403501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4726640-3501
LICENSED CLINICAL SOCIAL WORKER - LICENSED NUMBER
UT
Enumeration date
09/06/2006
Last updated
04/07/2012
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