Provider Demographics
NPI:1780002121
Name:PATIN, KARA (MSW)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:PATIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 WASHINGTON BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-3126
Mailing Address - Country:US
Mailing Address - Phone:801-317-8160
Mailing Address - Fax:
Practice Address - Street 1:2550 WASHINGTON BLVD
Practice Address - Street 2:STE 200
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-3126
Practice Address - Country:US
Practice Address - Phone:801-317-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical