Individual
RAQUE; BAIZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
532 N DEXTER ST APT 3, SLC, UT 84116-2780
(801) 808-1389
Mailing address
532 N DEXTER ST APT 3, SLC, UT 84116-2780
(801) 808-1389
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
UT
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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