Individual
BROOKE MASTROIANNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9450 S 1300 E, SANDY, UT 84094-5555
(801) 501-2131
Mailing address
9450 S 1300 E, SANDY, UT 84094-5555
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
6984420
WI
2084P0804X
Child & Adolescent Psychiatry Physician
0101273885
VA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
13477083-1205
UT
Other
Enumeration date
03/22/2017
Last updated
10/17/2023
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