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General NPI Number Information
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NPI Number | 1649834235
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Entity Type | Individual
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Provider Name | TAVIA VALDEZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/29/2019
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Last Update Date | 05/10/2025
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Provider Practice Location Address
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Address Line | 1708 E 5550 S STE 23
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City | OGDEN
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State | UT
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Zip | 84403-7038
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Country | US
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Telephone | 801-475-4673
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Fax | 801-528-3392
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Provider Business Mailing Address
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Address Line | 1718 N 2400 W
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City | CLINTON
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State | UT
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Zip | 84015-8270
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Country | US
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Telephone | 801-675-0634
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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 | 111663153501
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 1166315-3502
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License Number State | UT
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