Individual
LARA MIE FUNAKOSHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCSH
Contact information
Practice address
375 S CHIPETA WAY STE A200, SLC, UT 84108-1261
(801) 587-3345
(801) 587-3349
Mailing address
836 E GATEWOOD DR, SANDY, UT 84094-3009
(801) 643-4504
(801) 587-3345
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
230
UT
Other
Enumeration date
02/29/2024
Last updated
02/29/2024
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