Individual
EMMA GRACE WAGSTAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
45 W 9000 S STE 1, SANDY, UT 84070-2047
(801) 558-8281
Mailing address
3781 S FOREST HILLS DR, SALT LAKE CITY, UT 84106-4208
(801) 558-8281
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86294476
UT
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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