Individual
DALLY MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4432 W 1525 S, CEDAR CITY, UT 84720-4631
(435) 619-5521
Mailing address
4432 W 1525 S, CEDAR CITY, UT 84720-4631
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9852658-4102
UT
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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