Individual
ELISA LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2020 S LAKE ST, SALT LAKE CITY, UT 84105-3119
(801) 487-7778
(801) 487-2942
Mailing address
2020 S LAKE ST, SALT LAKE CITY, UT 84105-3119
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
89125963502
UT
Other
Enumeration date
07/11/2014
Last updated
07/11/2014
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