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General NPI Number Information
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NPI Number | 1588301808
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Entity Type | Individual
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Provider Name | MRS. CYDNEE LYNN WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 300 MATTERHORN DR
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City | PARK CITY
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State | UT
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Zip | 84098-5230
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Country | US
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Telephone | 385-275-2742
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Fax |
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Provider Business Mailing Address
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Address Line | 382 E BAIRD CIR
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City | SOUTH SALT LAKE
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State | UT
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Zip | 84115-4633
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Country | US
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Telephone | 385-646-7184
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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 | 4799675-3501
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License Number State | UT
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