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Individual

L BRENT HAFEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS

Contact information

Practice address
400 C ST, SALT LAKE CITY, UT 84143-1005
(801) 408-3897
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 408-3897

Taxonomy

Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
51475563601
UT

Other

Enumeration date
07/20/2006
Last updated
07/08/2007
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