Provider Demographics
NPI:1326235813
Name:A. PAIGE PALMER
Entity Type:Organization
Organization Name:A. PAIGE PALMER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:A. PAIGE
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-572-4613
Mailing Address - Street 1:825 E 4800 S STE 250
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5519
Mailing Address - Country:US
Mailing Address - Phone:801-262-2305
Mailing Address - Fax:
Practice Address - Street 1:825 E 4800 S STE 250
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5519
Practice Address - Country:US
Practice Address - Phone:801-262-2305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT86 131 972 35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty