Healthcare Provider Details

I. General information

NPI: 1326898198
Provider Name (Legal Business Name): CHRISTOPHER GARRARD BSW, SSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9623 S AMBER LN
SANDY UT
84094-3636
US

IV. Provider business mailing address

9623 S AMBER LN
SANDY UT
84094-3636
US

V. Phone/Fax

Practice location:
  • Phone: 385-484-8464
  • Fax:
Mailing address:
  • Phone: 385-484-8464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14200045-3503
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: