Marie Eleanor Roushar, CSW
Social Worker, Clinical in Pleasant Grove, UT. Individual provider (NPI-1).
NPI number1174875488
StatusActive
Last updated in NPPESOct 10, 2012
Details
- NPI
- 1174875488
- Entity type
- Individual (NPI-1)
- Name
- Marie Eleanor Roushar
- Credential
- CSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 10, 2012
- Last updated
- Oct 10, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 8265368-3502 | UT | Yes |
Practice location
194 S Main StPleasant Grove, UT 84062-2631
Phone 801-785-1169 · Fax 801-785-1154
Mailing address
194 S Main StPleasant Grove, UT 84062-2631
Phone 801-785-1169 · Fax 801-785-1154
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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