Basic Information
| Provider Information | |||||||||
| NPI: | 1598791816 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMERON | ||||||||
| FirstName: | ROSALEA | ||||||||
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| Credential: | M.CL.SC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1920 S 1300 E | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841053612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015821565 | ||||||||
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| Practice Location | |||||||||
| Address1: | 151 A-BUILDING # 2 | ||||||||
| Address2: | 500 FOOTHILL BLVD VASLCHCS | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841480001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015821565 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 374612-4102 | UT | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.