Individual
TALIA JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 S 600 E, 3C, SALT LAKE CITY, UT 84102-2003
(801) 322-4257
Mailing address
207 S 600 E, 3C, SALT LAKE CITY, UT 84102-2003
(801) 322-4257
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/30/2015
Last updated
07/30/2015
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