Bollow, Susan Michelle
Bollow, Susan Michelle is an individual health care provider with primary practice located at 4444 S 700 E Ste 102 , Millcreek UT 84107-3075. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bollow, Susan Michelle can be contacted via phone (385) 321-3109.Contact Information
Primary practice address
4444 S 700 E Ste 102
Millcreek UT 84107-3075
Phone: (385) 321-3109
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 7046059-3502 | Utah |
Profile Details
| NPI number | 1275769259 |
|---|---|
| LBN Legal business name | Bollow, Susan Michelle |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 4th, 2009 |
| Last updated | Oct 3rd, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275769259 | NPPES |
| Utah | MEDICAID | 1275769259 |
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