Individual
TINA LYN BRAITHWAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11075 S STATE ST, SANDY, UT 84070-5164
(801) 360-7777
Mailing address
109 E WILDFLOWER CT, SARATOGA SPRINGS, UT 84045-8156
(801) 360-7777
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10390942-6009
UT
Other
Enumeration date
08/08/2017
Last updated
08/08/2017
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