Individual
LACEY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4035 S 500 E, MURRAY, UT 84107-1866
(801) 262-9181
Mailing address
2200 S FOOTHILL DR APT 203G, SALT LAKE CITY, UT 84109-3933
(254) 855-4389
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10316492-4102
UT
235Z00000X
Speech-Language Pathologist
SLP6929
NM
Other
Enumeration date
04/02/2018
Last updated
09/11/2019
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