Individual
ALYSSA KAY STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., C.D.
Contact information
Practice address
1160 E 3900 S # G-100, SALT LAKE CITY, UT 84124-1202
(801) 268-7479
(801) 268-7622
Mailing address
2265 S 1300 W STE B, SALT LAKE CITY, UT 84119-7233
(385) 388-8024
(385) 770-7662
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
5986583-4901
UT
Other
Enumeration date
09/17/2009
Last updated
01/31/2019
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