Individual
BRADEN CONSOLVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
519 W CENTER ST, PLEASANT GROVE, UT 84062-2215
(801) 310-6880
Mailing address
519 W CENTER ST, PLEASANT GROVE, UT 84062-2215
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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