Individual
LISA DAWN EASTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
697 W 4170 S, MURRAY, UT 84123-1326
(801) 587-2460
(801) 281-5787
Mailing address
697 W 4170 S, MURRAY, UT 84123-1326
(801) 587-2460
(801) 281-5787
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
—
—
Other
Enumeration date
05/03/2016
Last updated
05/03/2016
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