Tracy Burnham, L.C.S.W.
Social Worker, Clinical in Centerville, UT. Individual provider (NPI-1).
NPI number1386196830
StatusActive
Last updated in NPPESNov 1, 2016
Details
- NPI
- 1386196830
- Entity type
- Individual (NPI-1)
- Name
- Tracy Burnham
- Credential
- L.C.S.W.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 1, 2016
- Last updated
- Nov 1, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 10129124-3501 | UT | Yes |
Practice location
94 E Pages LnSuite A
Centerville, UT 84014-2216
Phone 801-294-0578
Mailing address
94 E Pages LnSuite A
Centerville, UT 84014-2216
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