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Individual

MAKENNA ROSE WOERNLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1650 W GENTILE ST, LAYTON, UT 84041-7210
(801) 485-8051
Mailing address
1652 S 250 W APT J112, OGDEN, UT 84404

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AD007462J
DRIVERS LICENSE
ID
Enumeration date
08/09/2022
Last updated
08/09/2022
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