Provider Demographics
NPI:1053790220
Name:CHARD, MIA NORMA (CSW)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:NORMA
Last Name:CHARD
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 1:2036 LINCOLN AVE STE 103B
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-6525
Mailing Address - Country:US
Mailing Address - Phone:801-719-7737
Mailing Address - Fax:
Practice Address - Street 1:2036 LINCOLN AVE STE 103B
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-6525
Practice Address - Country:US
Practice Address - Phone:801-719-7737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical