Individual
MEGAN MARIE WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Mailing address
125 N MILL RD UNIT E404, VINEYARD, UT 84058-5622
(503) 410-8335
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
2747980
OR
Other
Enumeration date
04/17/2017
Last updated
04/17/2017
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