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Organization

LISA RECTOR, LCSW

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA M RECTOR LCSW (OWNER)
(801) 870-4812
Entity
Organization

Contact information

Practice address
4505 S WASATCH BLVD, SUITE 190, SALT LAKE CITY, UT 84124-4709
(801) 870-4812
Mailing address
4505 S WASATCH BLVD, SUITE 190, SALT LAKE CITY, UT 84124-4709
(801) 870-4812

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6502434-3501
UT

Other

Enumeration date
05/05/2014
Last updated
05/05/2014
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