Individual
GRACE WARNER GOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, CD
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 231-8720
Mailing address
2574 E SAGE WAY, SALT LAKE CITY, UT 84109-1313
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1062797
UT
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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