Healthcare Provider Details

I. General information

NPI: 1467398628
Provider Name (Legal Business Name): INDIA SABRINA WORKMAN CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: INDIA ELDREDGE CSW

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 S 300 W
BLANDING UT
84511-3921
US

IV. Provider business mailing address

1478 EAST HIGHWAY 162
MONTEZUMA CREEK UT
84534-0130
US

V. Phone/Fax

Practice location:
  • Phone: 435-678-0700
  • Fax:
Mailing address:
  • Phone: 435-678-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14239269-3502
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: