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1972195634
JULIET PACK TIETJEN
LOGAN, UT
NPI
1972195634
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: UT 10853173-3902)
Enumeration Date
2021-02-04
Last Update Date
2021-02-04
Business Address
JULIET PACK TIETJEN LMFT
2150 N MAIN ST STE 9
LOGAN, UT 84341-1740
Phone number: 435-554-8647
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Mailing Address
JULIET PACK TIETJEN LMFT
136 HILLSIDE DR
SMITHFIELD, UT 84335-2540
Phone number: 435-760-6769
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