Individual
CASSIDY T IMMAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 W 5600 S, ROY, UT 84067-1372
(385) 380-9697
Mailing address
2700 W 5600 S, ROY, UT 84067-1372
(385) 380-9697
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
01/02/2025
Last updated
01/02/2025
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