Robert Wilcox-Ulikoki Cline, LCSW

Individual provider Active NPI Clinical Social Worker · Eagle Mountain, UT

NPI 1629316450 · NPPES record last updated Jan 29, 2013

Key facts

NPI
1629316450
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
7388313-3501 (UT)
Practice address
1952 Revere Way
Eagle Mountain, UT 84005-6042
Phone
(801) 427-5444
NPI assigned
Jan 29, 2013
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7388313-3501UTMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7388313-3501 UT Yes

Addresses

Primary practice location

1952 Revere Way
Eagle Mountain, UT 84005-6042

Mailing address

1952 Revere Way
Eagle Mountain, UT 84005-6042
Phone (801) 427-5444

Other names

  • Mr. Koki Cline Other name

Other providers in Eagle Mountain, UT

All providers in Eagle Mountain, UT · Clinical Social Worker in Utah

Sources for this page

Verify at the official NPI Registry.