Individual
MISTY FONNESBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
523 HERITAGE PARK BLVD STE 4, LAYTON, UT 84041-5611
(801) 525-9998
Mailing address
523 HERITAGE PARK BLVD STE 4, LAYTON, UT 84041-5611
(801) 525-9998
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/26/2019
Last updated
05/23/2024
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