Individual
ALICIA JEANNE TIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
607 E 200 S, SALT LAKE CITY, UT 84102-2110
(801) 322-4257
Mailing address
931 S 300 E, SALT LAKE CITY, UT 84111-4614
(267) 345-6003
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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