Individual
KALISITIANE ULUAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 GOLF COURSE RD STE E, LOGAN, UT 84321-5934
(435) 799-5035
Mailing address
115 GOLF COURSE RD STE E, LOGAN, UT 84321-5934
(435) 799-5035
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12260180-3506
UT
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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