Individual
LEAH FUKOFUKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
934 S MAIN ST, LAYTON, UT 84041-7135
(801) 773-7060
Mailing address
934 S MAIN ST, LAYTON, UT 84041-7135
(801) 773-7060
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2020
Last updated
04/29/2020
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