Individual
SHANNON BROOKE GRIZZLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
4052 W PIONEER PKWY, WEST VALLEY CITY, UT 84120-2062
(801) 964-3111
Mailing address
4052 W PIONEER PKWY, WEST VALLEY CITY, UT 84120-2062
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9663252-3502
UT
Other
Enumeration date
02/12/2019
Last updated
02/12/2019
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