Individual
DR. KATIE LYNNE BRUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
2091 E 1300 S STE 104, SALT LAKE CITY, UT 84108-2277
(801) 783-3801
(833) 606-3378
Mailing address
2091 E 1300 S STE 104, SALT LAKE CITY, UT 84108-2277
(801) 783-3801
(833) 606-3378
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
NT60359284
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11065179-7100
NATUROPATHIC PHYSICIAN LICENSE
UT
01
—
NT60359284
NATUROPATHIC PHYSICIAN LICENSE
WA
Enumeration date
09/30/2011
Last updated
03/07/2023
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