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1639449382
KEITH MICHAEL LEDERHAUS
SALT LAKE CITY, UT
NPI
1639449382
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-01-11
Last Update Date
2012-01-11
Business Address
Mr. KEITH MICHAEL LEDERHAUS CSW
344 E 100 S
SALT LAKE CITY, UT 84111-1700
Phone number: 801-322-4257
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Mailing Address
Mr. KEITH MICHAEL LEDERHAUS CSW
474 7TH AVE UNIT B
SALT LAKE CITY, UT 84103-3046
Phone number:
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