Individual
SHELLY A SCHAEFFERKOETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
344 E 100 S, SALT LAKE CITY, UT 84111
(801) 322-3397
Mailing address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
(801) 322-3397
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
4649
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74175
—
ND
Enumeration date
02/20/2012
Last updated
11/11/2019
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