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Individual

MICHELLE REINA BOSLEY HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2000 S 900 E, SALT LAKE CITY, UT 84105-3208
(801) 464-7800
Mailing address
1055 S 1200 E, SALT LAKE CITY, UT 84105-1524
(512) 705-6161

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
8303357-1205
UT
208000000X
Pediatrics Physician
BP10035444
TX
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
8303357-1205
UT
2080P0203X
Pediatric Critical Care Medicine Physician
DR.0056489
CO

Other

Enumeration date
06/16/2009
Last updated
01/30/2024
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