Individual
KRYSTAL MITCHELL LEAAETOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1672 W 700 S, SUITE D, SPRINGVILLE, UT 84663-4963
(801) 489-9721
Mailing address
1672 W 700 S, SUITE D, SPRINGVILLE, UT 84663-4963
(801) 489-9721
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7114746-3502
UT
Other
Enumeration date
06/27/2012
Last updated
06/27/2012
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