Provider Demographics
NPI:1841788890
Name:STEFFENSEN, DAINA R (CASE MANAGER)
Entity Type:Individual
Prefix:
First Name:DAINA
Middle Name:R
Last Name:STEFFENSEN
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3548 S CENTENNIAL RD
Mailing Address - Street 2:
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-2463
Mailing Address - Country:US
Mailing Address - Phone:385-333-3021
Mailing Address - Fax:
Practice Address - Street 1:6856 S 700 E
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-5753
Practice Address - Country:US
Practice Address - Phone:801-743-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator