Provider Demographics
NPI:1780647123
Name:HARPER, MIRIAM R (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:R
Last Name:HARPER
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 1:11075 S STATE ST STE 14
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-5194
Mailing Address - Country:US
Mailing Address - Phone:801-676-8796
Mailing Address - Fax:801-676-8797
Practice Address - Street 1:11075 S STATE ST STE 14
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-5194
Practice Address - Country:US
Practice Address - Phone:801-676-8796
Practice Address - Fax:801-676-8797
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5341287-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical