Individual
LAURA DELOACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCHIATRIC APRN
Contact information
Practice address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
500 FOOTHILL BLVD # 16, SALT LAKE CITY, UT 84148-5255
(801) 582-1565
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9166517-4405
UT
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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