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NPI Code Detail

MEDICARE: MS. WENDY L COLLINS M.S.W., L.C.S.W.

MEDICARE: MS. WENDY L COLLINS M.S.W., L.C.S.W.
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 Worker7053017-3501UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295761161
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. WENDY L COLLINS M.S.W., L.C.S.W.
Provider Business Mailing Address
First Line : 2950 S 2000 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-1918
Country : US
Telephone Number : 201-923-8246
Fax Number :
Provider Business Practice Location Address
First Line : 3944 S 400 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84107-1600
Country : US
Telephone Number : 801-261-1442
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 09/04/2008

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