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Individual

MALLORY R SDANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LCGC

Contact information

Practice address
423 S WAKARA WAY, SUITE 200, SALT LAKE CITY, UT 84108-1242
(801) 931-6228
Mailing address
423 S WAKARA WAY, SUITE 200, SALT LAKE CITY, UT 84108-1242

Taxonomy

Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
8118447-3601
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8118447-3601
GENETIC COUNSELING LICENSE
UT
Enumeration date
01/07/2013
Last updated
01/07/2013
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