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Contact Information

ANDREA E BOTT
2072 N MAIN ST STE 205
NORTH LOGAN, UT84341-1700
 Phone: 435-213-1638
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Social Worker

104100000X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for ANDREA E BOTT · (Female)

NPI # 1285278572
Status Active
Credentials
Entity Individual
Enumeration date 10/30/2019
Last updated 07/26/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 6790474-3502
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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