MEDICARE: KRISTI ROBLES 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
1	1041C0700X	Clinical Social Worker	6604883-3501	UT

General Provider Information

NPI Number	:	1801069034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTI ROBLES LCSW

Provider Business Mailing Address
First Line	:	PO BOX 844
Second Line	:
City	:	LEHI
State	:	UT
Zip	:	84043-0844
Country	:	US
Telephone Number	:	801-400-2798
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 E 5600 S
Second Line	:	SUITE 312
City	:	MURRAY
State	:	UT
Zip	:	84107-6174
Country	:	US
Telephone Number	:	801-893-1177
Fax Number	:

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

Provider Enumeration Date	:	04/09/2008
Last Update Date	:	06/24/2016

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Directions to “ KRISTI ROBLES LCSW” Practice Location

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