Individual
MRS. MIRANDA DIANE WILCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
423 E 5600 S APT 9, MURRAY, UT 84107-6281
(801) 979-1733
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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