MEDICARE: DENISE SANDERS CSW

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
1	1041C0700X	Clinical Social Worker	12672453-3502	UT

General Provider Information

NPI Number	:	1659148518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE SANDERS CSW

Provider Business Mailing Address
First Line	:	976 E HUDSON AVE
Second Line	:
City	:	MILLCREEK
State	:	UT
Zip	:	84106-2117
Country	:	US
Telephone Number	:	801-792-5477
Fax Number	:

Provider Business Practice Location Address
First Line	:	1334 E INTEGRA CT
Second Line	:
City	:	MILLCREEK
State	:	UT
Zip	:	84106-4412
Country	:	US
Telephone Number	:	801-449-0426
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2023
Last Update Date	:	12/11/2023

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Directions to “ DENISE SANDERS CSW” Practice Location

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