Healthcare Provider Details

I. General information

NPI: 1497667224
Provider Name (Legal Business Name): STEPHANIE DUTSON SSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N MALL DR STE R123
ST GEORGE UT
84790-7350
US

IV. Provider business mailing address

321 N MALL DR STE R104
ST GEORGE UT
84790-7302
US

V. Phone/Fax

Practice location:
  • Phone: 435-705-8132
  • Fax: 435-215-2576
Mailing address:
  • Phone: 435-705-8132
  • Fax: 435-215-2576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14311325-3503
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: