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1356778377
MYRNA SUZANNE GILLIS
PROVO, UT
NPI
1356778377
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: UT 104100000X)
Enumeration Date
2013-10-04
Last Update Date
2017-01-24
Business Address
-- MYRNA SUZANNE GILLIS LAMFT
1726 BUCKLEY DRIVE
PROVO, UT 84606
Phone number: 801-373-6562
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Mailing Address
-- MYRNA SUZANNE GILLIS LAMFT
857 EAST 200 SOUTH
SALT LAKE CITY, UT 84102
Phone number: 801-487-3276
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