Individual
IVANNA MARIA FUENTES JAVIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2240 ADAMS AVE, OGDEN, UT 84401-1511
(801) 393-5355
Mailing address
2240 ADAMS AVE, OGDEN, UT 84401-1511
(801) 393-5355
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
128960863501
UT
Other
Enumeration date
05/02/2024
Last updated
05/02/2024
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