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General NPI Number Information
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NPI Number | 1063987543
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Entity Type | Individual
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Provider Name | NATEASA LYNN MCGUIRE LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/10/2018
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Last Update Date | 10/10/2018
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Provider Practice Location Address
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Address Line | 2202 N MAIN ST STE 301
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City | CEDAR CITY
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State | UT
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Zip | 84721-9791
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Country | US
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Telephone | 319-541-4485
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Fax |
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Provider Business Mailing Address
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Address Line | 107 S 400 E
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City | CEDAR CITY
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State | UT
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Zip | 84720-3323
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9821460-3501
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License Number State | UT
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