Individual
LISA MARION SLADYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1161 E 300 N, PROVO, UT 84606-3539
(801) 377-4668
Mailing address
710 S 320 W, PROVO, UT 84601-5830
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
277003-3102
UT
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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