Basic Information
| Provider Information | |||||||||
| NPI: | 1518455518 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUFF | ||||||||
| FirstName: | MICHELE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | CSW MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 867 | ||||||||
| Address2: | |||||||||
| City: | PRICE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 845010867 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4356377200 | ||||||||
| FaxNumber: | 4356372377 | ||||||||
| Practice Location | |||||||||
| Address1: | 45 EAST 100 SOUTH | ||||||||
| Address2: | |||||||||
| City: | CASTLEDALE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4353812432 | ||||||||
| FaxNumber: | 4353812542 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2018 | ||||||||
| LastUpdateDate: | 04/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 3105131-3502 | UT | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.