MEDICARE: WENDI ANN DUNFORD CSW

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	49352193502	UT

General Provider Information

NPI Number	:	1659452936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDI ANN DUNFORD CSW

Provider Business Mailing Address
First Line	:	1965 DOWNINGTON AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-2913
Country	:	US
Telephone Number	:	801-463-1086
Fax Number	:

Provider Business Practice Location Address
First Line	:	132 S STATE ST STE 100
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84111-1506
Country	:	US
Telephone Number	:	801-240-6500
Fax Number	:

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/08/2007

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Directions to “ WENDI ANN DUNFORD CSW” Practice Location

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