MEDICARE: PATRICIA POZERNICK

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	1041S0200X	School Social Worker

General Provider Information

NPI Number	:	1720331499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA POZERNICK

Provider Business Mailing Address
First Line	:	148 DAYBREAK LN
Second Line	:
City	:	SARATOGA SPRINGS
State	:	UT
Zip	:	84045-4879
Country	:	US
Telephone Number	:	801-822-3853
Fax Number	:

Provider Business Practice Location Address
First Line	:	344 EAST 100 SOUTH
Second Line	:	SUITE 301
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84045-4879
Country	:	US
Telephone Number	:	801-322-4257
Fax Number	:

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

Provider Enumeration Date	:	10/18/2012
Last Update Date	:	10/18/2012

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Directions to “ PATRICIA POZERNICK ” Practice Location

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