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NPI Code Detail

MEDICARE: MARCOS ALBERTO UBOLDI LCSW

MEDICARE: MARCOS ALBERTO UBOLDI 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 Worker5722595-3501UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NONEOTHERLCSW

General Provider Information

NPI Number : 1568980449
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCOS ALBERTO UBOLDI LCSW
Provider Business Mailing Address
First Line : 3518 WASHINGTON BLVD
Second Line :
City : OGDEN
State : UT
Zip : 84403-1034
Country : US
Telephone Number : 801-399-1600
Fax Number :
Provider Business Practice Location Address
First Line : 3518 WASHINGTON BLVD
Second Line :
City : OGDEN
State : UT
Zip : 84403-1034
Country : US
Telephone Number : 801-399-1600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2017
Last Update Date : 06/16/2018

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Directions to “ MARCOS ALBERTO UBOLDI LCSW” Practice Location

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