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1568034114
STACIE ELISE LATER
LOGAN, UT
NPI
1568034114
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: UT 7886666-3506)
Enumeration Date
2021-07-13
Last Update Date
2021-07-13
Business Address
STACIE ELISE LATER
115 GOLF COURSE RD STE E
LOGAN, UT 84321-5934
Phone number: 435-535-3782
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Mailing Address
STACIE ELISE LATER
115 GOLF COURSE RD STE E
LOGAN, UT 84321-5934
Phone number:
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