Most Relevant Information
Provider Data
| NPI Number: | 1003413964 |
| Provider Name: | MICHELLE ANKLAN LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 11169782-3502 |
Most Important Dates
| Enumeration Date: | 10/05/2020 |
| Last Updated: | 06/14/2022 |
Provider Practice Location
159 W BROADWAY # 200-201
SALT LAKE CITY
UT
841011907
Practice Location Phone/Fax
| Phone: | 3852026104 |
| Fax: |
Provider Mailing Location
159 W BROADWAY # 200-201
SALT LAKE CITY
UT
841011907
Provider Mailing Phone/Fax
| Phone: | 3852026104 |
| Fax: |