Individual
JESSICA GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
81 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1125
(801) 662-1640
Mailing address
180 E 5460 S APT 24, MURRAY, UT 84107-6080
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86147866
UT
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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