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General NPI Number Information
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NPI Number | 1790096410
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Entity Type | Individual
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Provider Name | MALETA ANNE BARELA SSW
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Gender | Female
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Dates
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Enumeration Date | 06/28/2010
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Last Update Date | 09/26/2013
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Provider Practice Location Address
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Address Line | 883 W 4100 S
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City | RIVERDALE
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State | UT
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Zip | 84405-2685
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Country | US
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Telephone | 801-721-6231
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Fax |
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Provider Business Mailing Address
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Address Line | 883 W 4100 S
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City | RIVERDALE
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State | UT
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Zip | 84405-2685
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Country | US
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Telephone | 801-721-6231
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 7273837-3503
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 72738373503
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License Number State | UT
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