Individual
MS. TIFFANY ANN SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CM
Contact information
Practice address
1522 S 1100 E, SALT LAKE CITY, UT 84105-2425
(801) 467-1200
(801) 467-1210
Mailing address
1522 S 1100 E, SALT LAKE CITY, UT 84105-2425
(801) 467-1200
(801) 467-1210
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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