Individual
TYRA MAE VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3375 S 880 E, SALT LAKE CITY, UT 84106
(801) 428-3410
Mailing address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
(801) 322-3222
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/04/2020
Last updated
09/04/2020
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