Individual
MRS. MARY ELIZABETH FEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
344 E 100 S, STE 301, SALT LAKE CITY, UT 84111-1700
(801) 922-4257
Mailing address
1270 MANDALAY RD, SALT LAKE CITY, UT 84116-4302
(801) 953-0186
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8019530186
—
UT
Enumeration date
06/22/2011
Last updated
06/22/2011
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