Individual
MR. JUANCARLOS SANTISTEBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2404 N 3400 W # B, PLAIN CITY, UT 84404-8579
(801) 458-8408
(801) 458-8408
Mailing address
2404 N 3400 W # B, PLAIN CITY, UT 84404-8579
(801) 458-8408
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
9090848-3902
UT
Other
Enumeration date
03/11/2008
Last updated
06/17/2016
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