Individual
MAURI WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1776 S MAIN ST, SALT LAKE CITY, UT 84115-1951
(208) 351-1867
Mailing address
957 E CREEKHILL LN APT 31, MIDVALE, UT 84047-2364
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
9045583-3502
UT
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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