Individual
TINA ANNETTE BRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6363 S FAUST WAY, TAYLORSVILLE, UT 84129-6359
(801) 955-9110
Mailing address
6363 S FAUST WAY, TAYLORSVILLE, UT 84129-6359
(801) 955-9110
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5327658-3502
UT
Other
Enumeration date
09/01/2015
Last updated
09/01/2015
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