Provider Demographics
NPI:1295359156
Name:HUBRICH, KATELYN (CSW)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:HUBRICH
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:HUBRICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:873 W BAXTER DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-8506
Mailing Address - Country:US
Mailing Address - Phone:801-446-3515
Mailing Address - Fax:801-601-1578
Practice Address - Street 1:873 W BAXTER DR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-8506
Practice Address - Country:US
Practice Address - Phone:801-446-3515
Practice Address - Fax:801-601-1578
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical