Individual
MISTY MADDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15257 S SCENIC CREST CIR, BLUFFDALE, UT 84065-5076
(801) 577-3086
Mailing address
15257 S SCENIC CREST CIR, BLUFFDALE, UT 84065-5076
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/15/2019
Last updated
11/15/2019
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