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NPI Code Detail

MEDICARE: GABRIELA VICTORIA CETROLA LCSW

MEDICARE: GABRIELA VICTORIA CETROLA 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 Worker3165663501UT

General Provider Information

NPI Number : 1962460790
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIELA VICTORIA CETROLA LCSW
Provider Business Mailing Address
First Line : 1588 MAJOR ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-1631
Country : US
Telephone Number : 801-467-6060
Fax Number : 801-466-6919
Provider Business Practice Location Address
First Line : 1588 MAJOR ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-1631
Country : US
Telephone Number : 801-467-6060
Fax Number : 801-466-6919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2006
Last Update Date : 07/08/2007

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Directions to “ GABRIELA VICTORIA CETROLA LCSW” Practice Location

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