Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | ||
N | 104100000X | Social Worker | UT |
NPI | 1003428046 |
---|---|
Provider Name | Ms. Marika Rai Barber |
First Address | Holladay, UT 84124-3604 |
Second Address | West Valley, UT 84119-2668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2020 |
Last Update Date | 20/08/2020 |