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NPI Code Detail

MEDICARE: KAMI BALMFORTH LCSW

MEDICARE:   KAMI  BALMFORTH  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6152380-3501UT

General Provider Information

NPI Number : 1518909969
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAMI BALMFORTH LCSW
Provider Business Mailing Address
First Line : 1747 S 900 W
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84104-1716
Country : US
Telephone Number : 801-466-8353
Fax Number :
Provider Business Practice Location Address
First Line : 1747 S 900 W
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84104-1716
Country : US
Telephone Number : 801-466-8353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2006
Last Update Date : 06/17/2010

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Directions to “ KAMI BALMFORTH LCSW” Practice Location

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