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1386491819
IVANNA MARIA FUENTES JAVIER
OGDEN, UT
NPI
1386491819
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 128960863501)
Enumeration Date
2024-05-02
Last Update Date
2024-05-02
Business Address
IVANNA MARIA FUENTES JAVIER
2240 ADAMS AVE
OGDEN, UT 84401-1511
Phone number: 801-393-5355
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Mailing Address
IVANNA MARIA FUENTES JAVIER
2240 ADAMS AVE
OGDEN, UT 84401-1511
Phone number: 801-393-5355
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