Individual
MARIYA DETERLIZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
486 E WENDELL WAY, SOUTH SALT LAKE, UT 84115-4629
(801) 581-7766
Mailing address
486 E WENDELL WAY, SOUTH SALT LAKE, UT 84115-4629
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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