Doctor Name: | ANDREA ABBOTT |
NPI Number: | 1164728846 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CSW |
License Number: | 336291-3502 |
Business Practice Address: | 50 N Main St Tooele, UT - 840742139 |
Business Phone Number: | 4358508723 |
Business Fax Number: | 8017334083 |
Mailing Address: | Po Box 900245, SANDY |
State: | UT |
Postal Code: | 840900245 |
Phone Number: | 8016348727 |
Fax Number: | 8017334083 |
NPI Enumeration Date: | 01/28/2011 |
NPI Last Update Date: | 01/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 336291-3502 |
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 |