Individual
MICHELLE BRISENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
195 N 1950 W, SALT LAKE CITY, UT 84116-3100
(801) 682-0536
Mailing address
195 N 1950 W, SALT LAKE CITY, UT 84116-3100
(801) 682-0536
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
UT
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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