Provider Demographics
NPI:1609328145
Name:LEIGHTON, DONNA KAY (SSW)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:KAY
Last Name:LEIGHTON
Suffix:
Gender:F
Credentials:SSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12916 NATALIE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-8715
Mailing Address - Country:US
Mailing Address - Phone:801-662-8296
Mailing Address - Fax:
Practice Address - Street 1:150 E 700 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-3806
Practice Address - Country:US
Practice Address - Phone:801-364-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-01
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5850252-3503104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker