Individual
MADELEINE PUGMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
95 GOLF COURSE RD STE 105, LOGAN, UT 84321-5990
(435) 915-6398
Mailing address
95 GOLF COURSE RD STE 105, LOGAN, UT 84321-5990
(435) 915-6398
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
11772158-3501
UT
1041C0700X
Clinical Social Worker
Primary
11772158-3506
UT
Other
Enumeration date
05/19/2020
Last updated
03/07/2024
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