Provider Demographics
NPI:1649568452
Name:BUTTERFIELD, ANNI (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNI
Middle Name:
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7309 S 180 W
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1020
Mailing Address - Country:US
Mailing Address - Phone:801-569-2153
Mailing Address - Fax:801-567-9006
Practice Address - Street 1:7309 S 180 W
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1020
Practice Address - Country:US
Practice Address - Phone:801-569-2153
Practice Address - Fax:801-567-9006
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5931577-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical