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General NPI Number Information
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NPI Number | 1871957795
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Entity Type | Individual
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Provider Name | LILLIE MARIE PUZEY L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 610 N. KAYS DR. SUITE 101
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City | KAYSVILLE
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State | UT
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Zip | 84037
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Country | US
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Telephone | 801-923-8389
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Fax |
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Provider Business Mailing Address
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Address Line | 2952 S. 1375 W.
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City | SYRACUSE
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State | UT
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Zip | 84075-9067
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Country | US
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Telephone | 801-674-9516
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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 | 345305-3501
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License Number State | UT
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