Individual
MS. LISA CROUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
450 S 900 E STE 300, SALT LAKE CITY, UT 84102-3064
(801) 534-7906
Mailing address
4268 SHIRLEY LN, SALT LAKE CITY, UT 84124-3057
(801) 534-7906
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7630789-6009
UT
Other
Enumeration date
09/23/2009
Last updated
12/08/2011
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