Individual
JULIET PACK TIETJEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2150 N MAIN ST STE 9, LOGAN, UT 84341-1740
(435) 554-8647
Mailing address
136 HILLSIDE DR, SMITHFIELD, UT 84335-2540
(435) 760-6769
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
10853173-3902
UT
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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