MEDICARE: MS. BARBARA J DOBBS 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
1	1041C0700X	Clinical Social Worker	1381303501	UT

General Provider Information

NPI Number	:	1265539191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA J DOBBS LCSW

Provider Business Mailing Address
First Line	:	4505 S WASATCH BLVD
Second Line	:	SUITE 330 A
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-4709
Country	:	US
Telephone Number	:	801-263-4002
Fax Number	:	801-274-3780

Provider Business Practice Location Address
First Line	:	4505 S WASATCH BLVD
Second Line	:	SUITE 330 A
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-4709
Country	:	US
Telephone Number	:	801-263-4002
Fax Number	:	801-274-3780

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/24/2012

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