Lara Mie Funakoshi, CCSH

NPI #1619734357 in Slc, Utah

Provider Information

NPI Number: 1619734357
Entity Type: Individual
Name: Lara Mie Funakoshi, CCSH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Health Educator
Credential: CCSH
Enumeration Date: Feb 29, 2024
Last Updated: Feb 29, 2024

Practice Location

Address: 375 S CHIPETA WAY STE A200
City: Slc
State: Utah
ZIP Code: 84108-1261
Phone: (801) 587-3345

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Health Educator	174H00000X	Primary

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