Individual
ILENE F LAZENBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 E 200 N, LOGAN, UT 84321-4034
(435) 752-0750
Mailing address
1670 E 440 S, PRICE, UT 84501-3765
(801) 502-5034
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11841805-3502
UT
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
09/06/2018
Last updated
05/30/2023
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