Individual
KARISSA MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSS
Contact information
Practice address
91 E FORT UNION BLVD, MIDVALE, UT 84047-1531
(801) 569-1995
Mailing address
91 E FORT UNION BLVD, MIDVALE, UT 84047-1531
(801) 569-1995
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
111111111
UT
Other
Enumeration date
06/25/2024
Last updated
06/25/2024
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