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1255382610
RUDY JOHANSEN
SALT LAKE CITY, UT
NPI
1255382610
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 134481-3501)
Enumeration Date
2006-05-12
Last Update Date
2007-07-08
Business Address
-- RUDY JOHANSEN LCSW
500 FOOTHILL DR 116HO
SALT LAKE CITY, UT 84148-0001
Phone number: 801-582-1565
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Mailing Address
-- RUDY JOHANSEN LCSW
1470 S 235 W
OREM, UT 84058-7370
Phone number: 801-225-3532
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