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1699220442
GIANNINA FUENTES MENDIETA
BOUNTIFUL, UT
NPI
1699220442
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: UT 8483250-3503)
Enumeration Date
2016-08-22
Last Update Date
2023-11-27
Business Address
GIANNINA FUENTES MENDIETA LCSW
415 MEDICAL DR STE D101
BOUNTIFUL, UT 84010-8905
Phone number: 801-683-1062
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Mailing Address
GIANNINA FUENTES MENDIETA LCSW
415 MEDICAL DR STE D101
BOUNTIFUL, UT 84010-8905
Phone number: 801-683-1062
Copy
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