Individual
MRS. BROOKE MAUGHAN LISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1600 W ANTELOPE DR, LAYTON, UT 84041-1120
(801) 807-1000
Mailing address
1613 S 4700 W, OGDEN, UT 84401-9700
(435) 258-8817
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
11638306-4901
UT
Other
Enumeration date
03/20/2020
Last updated
03/20/2020
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