Individual
RAYLENE FOSSUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1361 N 1075 W STE 14, FARMINGTON, UT 84025-2876
(385) 316-7127
Mailing address
1361 N 1075 W STE 14, FARMINGTON, UT 84025-2876
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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