Stephanie Deherrera
Peer Specialist in Tooele, UT. Individual provider (NPI-1).
NPI number1316773286
StatusActive
Last updated in NPPESSep 9, 2024
Details
- NPI
- 1316773286
- Entity type
- Individual (NPI-1)
- Name
- Stephanie Deherrera
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 9, 2024
- Certification date
- Sep 9, 2024
- Last updated
- Sep 9, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | F24-114939 | UT | Yes |
Practice location
100 S 1000 WTooele, UT 84074-4010
Phone 435-843-3520
Mailing address
3725 W 4100 S Ste 201West Valley City, UT 84120-5427
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All 12 Peer Specialist providers in Tooele · All 746 providers in Tooele
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