Mark Douglas Mottonen in S Salt Lake - Clinical
Mark Douglas Mottonen - NPI 1861653784
Mark Douglas Mottonen is a Clinical in S Salt Lake, Utah. Mark Douglas Mottonen practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mark Douglas Mottonen is 1861653784. The last update date is 2021-11-30.
Mark Douglas Mottonen's current location address is 451 Bishop Federal Ln, S Salt Lake, Utah. You can contact this provider via phone number 8014877557 and fax number 8014686838. The mailing address for Mark Douglas Mottonen is 451 Bishop Federal Ln, S Salt Lake, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Douglas Mottonen |
|---|---|
| Address | 451 Bishop Federal Ln, S Salt Lake, Utah |
| Phone Number | 8014877557 |
| Fax Number | 8014686838 |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1861653784 |
|---|---|
| Provider Enumeration Date | 2008-06-23 |
| Last Updated Date | 2021-11-30 |
Provider Mailing Address Detail
| Address | 451 Bishop Federal Ln |
|---|---|
| City | S Salt Lake |
| State | Utah (UT) |
| Post Code | 841152357 |
| Phone Number | 8014877557 |
| Fax Number | 8014686838 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 139850-3501 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique provider identifier assigned to Mark Douglas Mottonen?
The Mark Douglas Mottonen has been issued the NPI (National Provider Identifier) 1861653784 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Can you provide the Mark Douglas Mottonen's physical address?
The Mark Douglas Mottonen is physically located at 451 Bishop Federal Ln, in the city of S Salt Lake, UT, with the postal code 841152357.
What is Mark Douglas Mottonen's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Mark Douglas Mottonen is Clinical, and the taxonomy code that categorizes this field of expertise is 1041C0700X.
On what date did the Mark Douglas Mottonen receive its 1861653784 assignment from the Centers for Medicare & Medicaid Services?
The Mark Douglas Mottonen was assigned its 1861653784 by the Centers for Medicare & Medicaid Services on 2008-06-23.
As of what date was the information regarding Mark Douglas Mottonen, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Mark Douglas Mottonen, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2021-11-30.