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Individual

DAISY ELIZABETH MAE LAEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ACMHC

Contact information

Practice address
411 N GRANT ST, SALT LAKE CITY, UT 84116-2725
(801) 359-8862
Mailing address
440 S 500 E, SALT LAKE CITY, UT 84102-2705

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
114575386009
UT

Other

Enumeration date
10/03/2019
Last updated
10/03/2019
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