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Antonio Shade, CSW
NPI 1497518716 · on the registry since 2024
Practice
- Address
- 3737 W 4100 S
West Valley City, UT 84120 - Phone
- (888) 949-4864
- Clinicians at this address
- 79
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-10-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah