Organization
INTERMOUNTAIN SENIOR CLINIC
Active
Parent organization
INTERMOUNTAIN HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN HEALTHCARE
Authorized official
KAY SUE SIMONS MSW, LCSW (LICENSED CLINICAL SOCIAL WORKER)
(801) 314-4550
Entity
Organization
Contact information
Practice address
5770 S 250E SUITE 210, MURRAY, UT 84107
(801) 314-4544
(801) 314-4565
Mailing address
5770 S 250E SUITE 210, MURRAY, UT 84107
(801) 314-4544
(801) 314-4565
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6262134-3501
UT
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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