Individual
MRS. FAN LEE KWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
7434 S STATE ST, MIDVALE, UT 84047-2014
(801) 566-4423
Mailing address
6294 TERRACE RIDGE DR, WEST VALLEY CITY, UT 84128-5604
(801) 964-5185
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
369290-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107018309101
U006
UT
01
—
802652
U002
UT
01
—
942938348KW1
U003
UT
01
—
Q10178
ICAR
UT
Enumeration date
01/25/2006
Last updated
08/08/2012
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