Provider Demographics
NPI:1427887298
Name:SONDRUP, AMY JANE (CSW)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:JANE
Last Name:SONDRUP
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 S 1350 W STE F30
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-3873
Mailing Address - Country:US
Mailing Address - Phone:801-979-6304
Mailing Address - Fax:
Practice Address - Street 1:1111 S 1350 W STE F30
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-3873
Practice Address - Country:US
Practice Address - Phone:801-979-6304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11774281-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical