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General NPI Number Information
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NPI Number | 1437730462
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Entity Type | Individual
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Provider Name | STUART PALMER JR. CSW
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Gender | Male
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 5500 W BAGLEY PARK RD
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City | WEST JORDAN
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State | UT
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Zip | 84081-5697
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Country | US
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Telephone | 801-282-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 8069 S OAKRIDGE PARK DR
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City | WEST JORDAN
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State | UT
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Zip | 84081-3128
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Country | US
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Telephone | 801-674-4148
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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 | 111064923502
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License Number State | UT
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