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NPI Code Detail

MEDICARE: CLAIRE R STOECKER LCSW

MEDICARE: CLAIRE R STOECKER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker49999853501UT

General Provider Information

NPI Number : 1093735565
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAIRE R STOECKER LCSW
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-265-3000
Fax Number :
Provider Business Practice Location Address
First Line : 5770 S 1500 W
Second Line :
City : TAYLORSVILLE
State : UT
Zip : 84123-5216
Country : US
Telephone Number : 801-265-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 07/08/2007

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