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Individual

BLAISE MARURI MENDENHALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700
Mailing address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
Primary
134007603501
UT
171M00000X
Case Manager/Care Coordinator
UT

Other

Enumeration date
10/24/2017
Last updated
06/05/2026
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