Individual
MS. MICHELLE VERONICA ISAAC-DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
774 E 2100 S STE 414, SALT LAKE CITY, UT 84106-1863
(385) 424-1361
Mailing address
2783 E NORA DR, SALT LAKE CITY, UT 84124-2025
(215) 805-4189
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10388767-3502
UT
1041C0700X
Clinical Social Worker
10388767-3501
UT
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/11/2019
Last updated
09/18/2023
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