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General NPI Number Information
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NPI Number | 1689568362
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Entity Type | Organization
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Legal Business Name | REAL TALK LLC
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 812 E 4800 S
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City | MURRAY
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State | UT
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Zip | 84107-5034
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Country | US
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Telephone | 801-382-9593
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Fax |
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Provider Business Mailing Address
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Address Line | 50 W BROADWAY STE 333
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City | SALT LAKE CITY
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State | UT
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Zip | 84101-2027
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Country | US
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Telephone | 801-382-9593
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SASHA G FREED
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Credential | LCSW
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Telephone | 435-640-7516
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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 |
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License Number State |
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