Individual
TRACY MARIE KELLERSBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1133 N MAIN ST STE 206, LAYTON, UT 84041-4875
(801) 689-7459
(801) 543-3330
Mailing address
1223 N 1120 W, CLINTON, UT 84015-8834
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9129313-4102
UT
Other
Enumeration date
12/09/2016
Last updated
12/09/2016
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