Individual
SERENA DANIELLE WEATHERHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
857 E 200 S, SALT LAKE CITY, UT 84102-2317
(801) 487-3276
Mailing address
7434 S STATE ST, MIDVALE, UT 84047-2014
(801) 437-9955
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/07/2019
Last updated
12/16/2019
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