Individual
DENISSE HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
879 S OREM BLVD STE 1, OREM, UT 84058-5030
(801) 802-8608
Mailing address
738 S 170 W, SPANISH FORK, UT 84660-4747
(424) 731-6006
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223222332
STATE ID
UT
Enumeration date
08/22/2020
Last updated
08/22/2020
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