Provider Demographics
NPI:1831563501
Name:LECUYER, KATIA (LDEM, CPM)
Entity type:Individual
Prefix:
First Name:KATIA
Middle Name:
Last Name:LECUYER
Suffix:
Gender:F
Credentials:LDEM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 E 900 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-1528
Mailing Address - Country:US
Mailing Address - Phone:888-755-7155
Mailing Address - Fax:801-723-3115
Practice Address - Street 1:4359 S HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84124-3539
Practice Address - Country:US
Practice Address - Phone:888-755-7155
Practice Address - Fax:801-723-3115
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9472656-3400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife