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NPI Code Detail

MEDICARE: MRS. SARAH OSWALD MOGZEC L.C.S.W.

MEDICARE: MRS. SARAH OSWALD MOGZEC 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 Worker2699813501UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1107012407101OTHERUTINTRMTN. HEALTH CARE
2942938348MOGOTHERUTEDUCATORS MUTUAL
3751646OTHERUTDESERET MUTUAL

General Provider Information

NPI Number : 1427038090
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SARAH OSWALD MOGZEC L.C.S.W.
Provider Business Mailing Address
First Line : 1042 RAMONA AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-3412
Country : US
Telephone Number : 801-487-4320
Fax Number :
Provider Business Practice Location Address
First Line : 1020 S MAIN ST STE 100
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84101-3194
Country : US
Telephone Number : 801-539-7000
Fax Number : 801-539-7050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2006
Last Update Date : 09/04/2012

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