Provider Demographics
NPI:1902047632
Name:NEILSON, TAMERA LEE (LCSW)
Entity type:Individual
Prefix:
First Name:TAMERA
Middle Name:LEE
Last Name:NEILSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TAMERA
Other - Middle Name:LEE
Other - Last Name:MCARTHUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:2134 GOLDEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-5751
Mailing Address - Country:US
Mailing Address - Phone:801-505-8745
Mailing Address - Fax:
Practice Address - Street 1:2134 GOLDEN VALLEY DR
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-5751
Practice Address - Country:US
Practice Address - Phone:801-505-8745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTLCSW306092135011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical