Individual
STEPHANIE DEHERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 S 1000 W, TOOELE, UT 84074-4010
(435) 843-3520
Mailing address
3725 W 4100 S STE 201, WEST VALLEY CITY, UT 84120-5427
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
F24-114939
UT
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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