Individual
SHANNON LUCKART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 S STATE ST, SOUTH SALT LAKE, UT 84115-3164
(385) 646-5000
Mailing address
7361 S 2345 W, WEST JORDAN, UT 84084-3105
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4892361-3502
UT
Other
Enumeration date
05/16/2022
Last updated
05/16/2022
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