Individual
TENILLE SEALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 E 200 N, LOGAN, UT 84321-4034
(435) 752-0750
Mailing address
655 S 300 W, BRIGHAM CITY, UT 84302-2805
(435) 723-0573
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8965042-3503
UT
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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