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1932868528
ILLUMINATE AND EVOLVE THERAPY
SALT LAKE CITY, UT
NPI
1932868528
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Entity Type
Organization
Authorized Contact
MONA LISA CHAVEZ ESQUEDA
Owner/Operator
801-633-6579
Organization Subpart ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2021-12-11
Last Update Date
2021-12-11
Business Address
ILLUMINATE AND EVOLVE THERAPY
3435 S BROOK VIEW LN
SALT LAKE CITY, UT 84106-1593
Phone number: 801-633-6579
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Mailing Address
ILLUMINATE AND EVOLVE THERAPY
3435 S BROOK VIEW LN
SALT LAKE CITY, UT 84106-1593
Phone number: 801-633-6579
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