Provider Demographics
NPI:1972828325
Name:PACHECO, ANALEE STEFFAN (CSW)
Entity Type:Individual
Prefix:
First Name:ANALEE
Middle Name:STEFFAN
Last Name:PACHECO
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 900245
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84090-0245
Mailing Address - Country:US
Mailing Address - Phone:801-634-8727
Mailing Address - Fax:801-733-4083
Practice Address - Street 1:8537 W 2700 S STE C
Practice Address - Street 2:
Practice Address - City:MAGNA
Practice Address - State:UT
Practice Address - Zip Code:84044-1223
Practice Address - Country:US
Practice Address - Phone:801-503-8937
Practice Address - Fax:801-733-4083
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6464465-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical