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1134587264
JESSICA SHADE
SALT LAKE CITY, UT
NPI
1134587264
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2016-02-03
Last Update Date
2016-02-03
Business Address
-- JESSICA SHADE
4460 S HIGHLAND DR #230
SALT LAKE CITY, UT 84124-3543
Phone number: 888-949-4864
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Mailing Address
-- JESSICA SHADE
4460 S HIGHLAND DR #230
SALT LAKE CITY, UT 84124-3543
Phone number: 888-949-4864
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