Dewitt, Mary Jann
Dewitt, Mary Jann is an individual health care provider with primary practice located at 1104 E Ashton Ave Ste 108 , Salt Lake City UT 84106-2348. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dewitt, Mary Jann can be contacted via phone (801) 510-4547.Contact Information
Primary practice address
1104 E Ashton Ave Ste 108
Salt Lake City UT 84106-2348
Phone: (801) 510-4547
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 308921-2501 | Utah |
Profile Details
| NPI number | 1730149295 |
|---|---|
| LBN Legal business name | Dewitt, Mary Jann |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 27th, 2006 |
| Last updated | Jul 7th, 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 | 1730149295 | NPPES |
| Utah | MEDICAID | D1487 |
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