Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 277799-3501 | UT |
NPI | 1003039827 |
---|---|
Provider Name | Diane B. Rowe |
First Address | St George, UT 84790-8178 |
Second Address | St George, UT 84790-7302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |