ELISA ANN LACOCK

SALT LAKE CITY, UT
NPI1669746400
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2012-02-24
Last Update Date2012-02-24
Business Address
-- ELISA ANN LACOCK
344 E 100 S
SALT LAKE CITY, UT 84111-1700
Phone number: 801-322-4257
Mailing Address
-- ELISA ANN LACOCK
102 PLUMTREE LN
MIDVALE, UT 84047-1109
Phone number: