Individual
MARISSA CORONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DEM
Contact information
Practice address
10886 S SHILLING AVE APT 2034, SOUTH JORDAN, UT 84095-4334
(510) 305-5460
Mailing address
10886 S SHILLING AVE APT 2034, SOUTH JORDAN, UT 84095-4334
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
—
—
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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