| Doctor Name: | CANDICE PACKER |
| NPI Number: | 1194022590 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CSW |
| License Number: | 7744469-3502 |
| Business Practice Address: | 130 W Main St Lehi, UT - 840432100 |
| Business Phone Number: | 8015283247 |
| Business Fax Number: | 8017530409 |
| Mailing Address: | 130 W Main St, LEHI |
| State: | UT |
| Postal Code: | 840432100 |
| Phone Number: | 8015283247 |
| Fax Number: | 8017530409 |
| NPI Enumeration Date: | 02/21/2011 |
| NPI Last Update Date: | 02/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 7744469-3502 |
| 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 |