MEDICARE: JANALYN DOLL GARRETT 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

General Provider Information

NPI Number	:	1285200147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANALYN DOLL GARRETT LCSW

Provider Business Mailing Address
First Line	:	420 A ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-2537
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2725 E PARLEYS WAY STE 130
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-1658
Country	:	US
Telephone Number	:	801-981-5825
Fax Number	:

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

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	06/01/2021

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