Individual
AUTUMN MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5427 W IMPERIA WAY, HERRIMAN, UT 84096-4865
(815) 501-5035
Mailing address
5427 W IMPERIA WAY, HERRIMAN, UT 84096-4865
(815) 501-5035
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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