Provider Demographics
NPI:1215308051
Name:SROKA-NELSON, CAITLIN
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:SROKA-NELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 E SOUTH TEMPLE STE 200
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1446
Mailing Address - Country:US
Mailing Address - Phone:385-378-5566
Mailing Address - Fax:801-326-4879
Practice Address - Street 1:807 E SOUTH TEMPLE STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1446
Practice Address - Country:US
Practice Address - Phone:385-378-5566
Practice Address - Fax:801-326-4879
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical