Individual
MRS. ADRIENNE MELISSA KOFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4625 S 2300 E STE 211, HOLLADAY, UT 84117-4582
(801) 865-1453
Mailing address
4052 S COMET CIR, HOLLADAY, UT 84124-1910
(801) 673-3938
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6625159-3506
UT
Other
Enumeration date
06/12/2007
Last updated
03/26/2015
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