Provider Demographics
NPI:1033828132
Name:NEWMAN, MARY L
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:L
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4557 N SPRING MEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-5744
Mailing Address - Country:US
Mailing Address - Phone:801-703-0575
Mailing Address - Fax:
Practice Address - Street 1:879 S OREM BLVD STE 1
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-5030
Practice Address - Country:US
Practice Address - Phone:801-802-8608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker