Individual
MIRANDA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
344 E 100 S, SLC, UT 84111-1700
(801) 428-3402
Mailing address
68 S 600 E, SLC, UT 84102-1007
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/10/2010
Last updated
06/10/2010
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