Provider Demographics
NPI:1225578875
Name:PLANT, GARRETT CORY
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:CORY
Last Name:PLANT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 26TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-2459
Mailing Address - Country:US
Mailing Address - Phone:307-349-8521
Mailing Address - Fax:
Practice Address - Street 1:533 26TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-2459
Practice Address - Country:US
Practice Address - Phone:801-628-3330
Practice Address - Fax:801-459-1200
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2020-03-26
Deactivation Date:2019-10-23
Deactivation Code:
Reactivation Date:2020-02-06
Provider Licenses
StateLicense IDTaxonomies
UT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical