Individual
LISA MANWARING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2655 S LAKE ERIE DR, WEST VALLEY, UT 84120-7350
(385) 441-4900
Mailing address
4197 S MAIN ST APT 505, MILLCREEK, UT 84107-5755
(801) 433-7662
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
103135653502
UT
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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