Provider Demographics
NPI:1881470748
Name:WARBURTON, LOUISE
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:WARBURTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 W 50 N STE W8
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2010
Mailing Address - Country:US
Mailing Address - Phone:435-790-2757
Mailing Address - Fax:435-789-4045
Practice Address - Street 1:365 W 50 N STE W8
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2010
Practice Address - Country:US
Practice Address - Phone:435-790-2757
Practice Address - Fax:435-789-4045
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9393312-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical