Individual
DR. GWEN LATENDRESSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM, PHD
Contact information
Practice address
10 S 2000 E, ROOM 448, SALT LAKE CITY, UT 84112-5880
(801) 587-9636
(801) 587-9838
Mailing address
10 S 2000 E, ROOM 448, SALT LAKE CITY, UT 84112-5880
(801) 587-9636
(801) 587-9838
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
95-216631-4402
UT
Other
Enumeration date
08/30/2008
Last updated
08/30/2008
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