Most Relevant Information
Provider Data
| NPI Number: | 1003304148 |
| Provider Name: | MICHAEL KEITH SLADE MSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/24/2018 |
| Last Updated: | 04/24/2018 |
Provider Practice Location
2872 S HIGHLAND DR
SALT LAKE CITY
UT
841063147
Practice Location Phone/Fax
| Phone: | 8014858051 |
| Fax: |
Provider Mailing Location
4660 S BROOKWILLOW CV APT F
MILLCREEK
UT
841178030
Provider Mailing Phone/Fax
| Phone: | 8018308643 |
| Fax: |