Doctor Name: | ANDREA EGBERT |
NPI Number: | 1386898146 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.S.W. |
License Number: | 7061711-3501 |
Business Practice Address: | 3564 S 7200 W Ste C Magna, UT - 840443507 |
Business Phone Number: | 8012502909 |
Business Fax Number: | 8012520444 |
Mailing Address: | 3564 S 7200 W Ste C, MAGNA |
State: | UT |
Postal Code: | 840443507 |
Phone Number: | 8012502909 |
Fax Number: | 8012520444 |
NPI Enumeration Date: | 11/06/2008 |
NPI Last Update Date: | 07/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 7061711-3501 |
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 |