Individual
IEESHA CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
447 W BEARCAT DR, SOUTH SALT LAKE, UT 84115-2519
(801) 355-2846
Mailing address
3472 S HEDRON PL APT 502, WEST VALLEY CITY, UT 84119-7909
(318) 237-8773
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
UT
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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