Individual
SHANNON BRERETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3610 S 1000 W, SOUTH SALT LAKE, UT 84119-7829
(888) 949-4864
Mailing address
3725 W 4100 S STE 201, WEST VALLEY CITY, UT 84120-5427
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
F24-114608
UT
Other
Enumeration date
07/01/2024
Last updated
08/28/2024
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