Individual
CASSIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4038 W 4450 S, WEST HAVEN, UT 84401-8446
(801) 645-3496
Mailing address
4038 W 4450 S, WEST HAVEN, UT 84401-8446
(801) 645-3496
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/25/2014
Last updated
08/25/2014
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