| Doctor Name: | JOELLYN ORCUTT MANVILLE |
| NPI Number: | 1003186438 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCSW |
| License Number: | 62205833501 |
| Business Practice Address: | 275 E South Temple Ste 202 Slc, UT - 841111247 |
| Business Phone Number: | 8016091055 |
| Business Fax Number: | 8019530271 |
| Mailing Address: | 275 E South Temple, Ste 202 SLC |
| State: | UT |
| Postal Code: | 841111247 |
| Phone Number: | 8016091055 |
| Fax Number: | 8019530271 |
| NPI Enumeration Date: | 01/02/2012 |
| NPI Last Update Date: | 05/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 62205833501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |