Individual
LISA D CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
11719 ZEPHYR WAY, SOUTH JORDAN, UT 84095-8196
(801) 597-0303
Mailing address
11719 ZEPHYR WAY, SOUTH JORDAN, UT 84095-8196
(801) 597-0303
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8041687-6009
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/22/2010
Last updated
05/16/2012
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