Individual
ENNIO D CARDOZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPSS
Contact information
Practice address
3269 S MAIN ST STE 230, SOUTH SALT LAKE, UT 84115-3769
(801) 935-4447
Mailing address
838 N SIR MICHAEL DR, SALT LAKE CITY, UT 84116-1545
(385) 285-9073
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1897
UT
Other
Enumeration date
11/07/2022
Last updated
06/18/2024
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