Individual
CHAELYNN VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
344 E 100 S STE 301, SALT LAKE CITY, UT 84111-1727
(801) 322-4275
Mailing address
9258 N DEERFIELD CIR, EAGLE MOUNTAIN, UT 84005-4175
(801) 935-0985
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
08/21/2015
Last updated
04/23/2019
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