Individual
ANN TALLEY COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSAC
Contact information
Practice address
7601 SOUTH REDWOOD RD., BUILDING E, WEST JORDAN, UT 84084
(801) 233-8670
(801) 233-8682
Mailing address
4187 S 3425 W, WEST VALLEY CITY, UT 84119-5079
(801) 755-1580
(801) 233-8682
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
68526866006
UT
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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