Individual
ISABEL MEDELLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4621 CAPE RIDGE LN, WEST VALLEY CITY, UT 84128-5626
(801) 706-0887
Mailing address
4621 CAPE RIDGE LN, SALT LAKE CITY, UT 84128-5626
(801) 706-0887
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/04/2011
Last updated
03/04/2011
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