Individual ProviderElizabeth Charlotte TeaSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720(801) 263-7100PECOS EnrollmentBased on the most recent information from CMS, provider Elizabeth Charlotte Tea does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1033498514Provider TypeIndividualFull NameTea, Elizabeth CharlotteGenderFemaleSole ProprietorNoEnumeration Date8/15/2011Last Updated5/18/2017Contact InformationPractice LocationPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720Phone(801) 263-7100FaxUnlisted FaxMailing LocationMailing AddressPO Box 572070, Salt Lake City, UT 84121-1720Phone(801) 263-7100FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense8272286-3501UtahCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer