Individual
NANCY GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
440 S 500 E, SALT LAKE CITY, UT 84102-2705
(801) 633-8217
Mailing address
440 S 500 E, SALT LAKE CITY, UT 84102-2705
(801) 633-8217
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
284834-3102
UT
Other
Enumeration date
02/06/2023
Last updated
02/06/2023
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