Individual
MS. DIANE M THREEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
660 S 200 E, SALT LAKE CITY, UT 84111-3835
(801) 355-1528
(801) 364-4085
Mailing address
1371 MURPHYS LN, SALT LAKE CITY, UT 84106-2931
(801) 355-1528
(801) 364-4085
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
943008720
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
943008720
—
UT
Enumeration date
11/15/2010
Last updated
11/15/2010
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