Individual
MS. MARY JACQUELINE GRAMER SMITHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1141 E 3900 S, STE A250, SALT LAKE CITY, UT 84124-1215
(801) 539-7000
(801) 539-7050
Mailing address
1020 S MAIN ST, SUITE 100, SALT LAKE CITY, UT 84101-3176
(801) 539-7022
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
266258-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005739005
RAILROAD MEDICARE
UT
01
—
186306
INTRMTN HEALTH CARE
UT
01
—
262026
DESERET MUTUAL
UT
01
—
942938348
CHAMPUS
UT
05
—
942938348014
—
UT
01
—
942938348GR2
EDUCATORS MUTUAL
UT
01
—
S77687
MEDICARE ADVANTAGE PLANS
UT
Enumeration date
01/30/2006
Last updated
08/09/2012
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